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**
PLEASE CHECK BACK SOON
Download the files above while you wait.







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: 1730178
Sex: F
Age:
State: NJ

Vax Date:
Onset Date: 04/14/2021
Rec V Date: 09/24/2021
Hospital: Y

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

Lab Data: Test Name: Transvaginal ultrasound scan; Result Unstructured Data: Normal; Test Name: Transvaginal ultrasound scan; Result Unstructured Data: Not reported

Allergies:

Symptom List: Dysphagia, Epiglottitis

Symptoms: VAGINAL BLEEDING; This spontaneous report received from a patient concerned an elderly, white, female. The patient's height, and weight were not reported. The patient's concurrent conditions included: lung cancer (2002), breast cancer (2007) and endometriosis, and other pre-existing medical conditions included: patient had history of fertility treatments for 8 years in 1960s. The patient was not pregnant at the time of reporting. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of administration was not reported, batch number: Unknown, and expiry: Unknown) dose was not reported, one total administered on 09-APR-2021 to left arm for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. Five days after vaccination, on 14-APR-2021, the patient began bleeding vaginally. The patient had bleeding again on an unspecified date, was admitted to the hospital on 20-APR-2021, stayed several days and received a blood transfusion. The patient was discharged from hospital on an unspecified date in APR-2021. The bleeding resolved after the hospital stay and patient had two transvaginal ultrasounds, the second being only a few weeks ago, with appearing normal results. The results of the first transvaginal ultrasound scan was not reported. On an unspecified date the patient visited emergency room/department. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from vaginal bleeding on APR-2021. This report was serious (Hospitalization Caused / Prolonged).; Sender's Comments: V0: 20210942041- Covid-19 vaccine ad26.cov2.s- Vaginal bleeding. This event(s) is considered not related. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There are other factors more likely to be associated with the event(s) than the drug. Specifically: MEDICAL HISTORY

Other Meds:

Current Illness: Breast cancer (Breast Cancer 2007); Endometriosis; Lung cancer (Lung cancer 2002)

ID: 1730179
Sex: U
Age:
State: NC

Vax Date:
Onset Date: 09/22/2021
Rec V Date: 09/24/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Anxiety, Dyspnoea

Symptoms: ADMINISTRATION OF EXPIRED VACCINE; This spontaneous report received from a health care professional concerned a patient of unspecified age and sex. The patient's height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin, and batch number were not reported) dose was not reported, administered on 22-SEP-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 22-SEP-2021, the patient experienced administration of expired vaccine. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of administration of expired vaccine was not reported. This report was non-serious.

Other Meds:

Current Illness:

ID: 1730180
Sex: F
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 09/24/2021
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: UPSET STOMACH; PLANTAR FASCIITIS IN LEFT HEEL; HEADACHE; This spontaneous report received from a patient concerned a 6 decade old female. The patient's height, and weight were not reported. The patient's concurrent conditions included: moderate to severe rheumatoid arthritis. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, intramuscular, batch number: Unknown) dose, start therapy date were not reported for prophylactic vaccination. The batch number was not reported. The Company is unable to perform follow-up to request batch/lot numbers. Non-company suspect drugs included: adalimumab (solution for injection in pre-filled pen, subcutaneous, batch number was not reported) dose, frequency, and therapy dates were not reported for moderate to severe rheumatoid arthritis. No concomitant medications were reported. On an unspecified date, the patient experienced upset stomach, plantar fasciitis in left heel, and headache. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from upset stomach, and headache, and was recovering from plantar fasciitis in left heel. This report was non-serious.

Other Meds:

Current Illness: Rheumatoid arthritis

ID: 1730181
Sex: M
Age:
State: NC

Vax Date:
Onset Date:
Rec V Date: 09/24/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: STIFFNESS IN THE NECK; RINGING IN THE EAR; This spontaneous report received from a consumer concerned a male of unspecified age. The patient's height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin, and batch number were not reported) dose, start therapy date were not reported for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On an unspecified date, the patient experienced stiffness in the neck, and ringing in the ear. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from stiffness in the neck, and ringing in the ear. This report was non-serious.

Other Meds:

Current Illness:

ID: 1730182
Sex: F
Age:
State: FL

Vax Date:
Onset Date: 09/22/2021
Rec V Date: 09/24/2021
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: FEELING FAINT; NAUSEA; PARESTHESIA IN THE EXTREMITIES AND TINGLING IN THE RIGHT HAND AND IN FEET; FEELING NUMBNESS IN THE LEFT ARM IMMEDIATELY AFTER RECEIVING THE INJECTION, WHICH RADIATED TO THE LEFT HAND AND FINGERS; This spontaneous report received from a patient concerned a 31 year old female. The patient's height, and weight were not reported. The patient's concurrent conditions included: dust allergy. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 212A21A, expiry: UNKNOWN) dose was not reported, administered on 22-SEP-2021 for prophylactic vaccination. No concomitant medications were reported. On 22-SEP-2021, the patient experienced feeling faint. On 22-SEP-2021, the patient experienced nausea. On 22-SEP-2021, the patient experienced paresthesia in the extremities and tingling in the right hand and in feet. On 22-SEP-2021, the patient experienced feeling numbness in the left arm immediately after receiving the injection, which radiated to the left hand and fingers. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from feeling faint, and nausea on 22-SEP-2021, had not recovered from paresthesia in the extremities and tingling in the right hand and in feet, and the outcome of feeling numbness in the left arm immediately after receiving the injection, which radiated to the left hand and fingers was not reported. This report was non-serious.

Other Meds:

Current Illness: Dust allergy

ID: 1730183
Sex: M
Age:
State: CA

Vax Date:
Onset Date: 09/22/2021
Rec V Date: 09/24/2021
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: EXPIRED VACCINE ADMINISTERED; This spontaneous report received from a health care professional concerned a 52 year old male. The patient's weight was 188 pounds, and height was 65 inches. The patient's concurrent conditions included: penicillin allergy, alcohol user, and non smoker. The patient experienced drug allergy when treated with codeine for drug used for unknown indication. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 201A21A, expiry: 21-SEP-2021) dose was not reported, administered on 22-SEP-2021 10:30 for prophylactic vaccination. No concomitant medications were reported. On 22-SEP-2021, the patient experienced expired vaccine administered. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of expired vaccine administered was not reported. This report was non-serious.

Other Meds:

Current Illness: Alcohol use (COUPLE OF BEERS HERE AND THERE); Non-smoker; Penicillin allergy (ALMOST ANAPHYLAXIS, HIVES)

Date Died:

ID: 1730184
Sex: M
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 09/24/2021
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: DEATH; HAD COVID AND DIDN'T KNOW IT; This spontaneous report received from a consumer via a company representative via Social media concerned a male of unspecified age, race and ethnicity. The patient's height, and weight were not reported. The patient's concurrent conditions included: covid-19. Patient had underlying health problems. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown, Expiry: Unknown) 1 total, dose, start therapy date were not reported for prophylactic vaccination. The batch number was not reported. Per procedure, no follow-up will be requested for this case. No concomitant medications were reported. As stated by reporter, "My uncle had covid and didn't know it. 3 days after his exposure he got the J&J shot. 7days after that he was dead. Both my uncle and father had underlying health problems. I was exposed to my uncle, aunt and father all at the same time when they had covid and didn't know it". The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient died of death on 2021, and the outcome of had covid and didn't know it was not reported. This report was serious (Death).; Sender's Comments: V0: 20210943824 -covid-19 vaccine ad26.cov2.s- Death. This event(s) is considered unassessable. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There is no information on any other factors potentially associated with the event(s).; Reported Cause(s) of Death: UNKNOWN CAUSE OF DEATH

Other Meds:

Current Illness: COVID-19

ID: 1730185
Sex: F
Age:
State: MT

Vax Date:
Onset Date: 09/22/2021
Rec V Date: 09/24/2021
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: VACCINE EXPOSURE DURING PREGNANCY; This spontaneous pregnancy report received from a patient concerned a 39 year old female. The patient's weight was 247 pounds, and height was 60 inches. The patient's concurrent conditions included: gestational diabetes, and other pre-existing medical conditions included: The patient was pregnant at the time of reporting. The patient experienced drug allergy when treated with dimeticone, and titanium dioxide. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 211A21A, expiry: UNKNOWN) dose was not reported, administered on 22-SEP-2021 for prophylactic vaccination. Concomitant medications included insulin aspart for gestational diabetes, and insulin human for gestational diabetes. On 22-SEP-2021, the patient experienced vaccine exposure during pregnancy. The date of the patient's last menstrual period was 01-APR-2021 and expected delivery date was 09-JAN-2022. The pregnancy was continuing. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of vaccine exposure during pregnancy was not reported. This report was non-serious.

Other Meds: NOVOLOG; NOVOLIN

Current Illness: Gestational diabetes (It is requiring long acting and fast acting insulin, both given in the AM and at bed time (Novolin and Novolog).)

ID: 1730186
Sex: M
Age:
State: KY

Vax Date:
Onset Date: 09/22/2021
Rec V Date: 09/24/2021
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: EXPIRED VACCINE ADMINISTERED; This spontaneous report received from a patient concerned a 37 year old male. The patient's height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 201A21A, expiry: 21-SEP-2021) dose was not reported, administered on 22-SEP-2021 for prophylactic vaccination. No concomitant medications were reported. On 22-SEP-2021, the patient experienced expired vaccine administered. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from expired vaccine administered. This report was non-serious.

Other Meds:

Current Illness:

ID: 1730187
Sex: F
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 09/24/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Diarrhoea, Nasal congestion

Symptoms: FLU LIKE SYMPTOMS; This spontaneous report received from a patient via a company representative concerned a female of unspecified age. The patient's height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unk) dose, start therapy date were not reported for prophylactic vaccination. The batch number was not reported. Per procedure, no follow-up will be requested for this case. No concomitant medications were reported. On an unspecified date, the patient experienced flu like symptoms. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from flu like symptoms. This report was non-serious.

Other Meds:

Current Illness:

ID: 1730188
Sex: F
Age:
State: TX

Vax Date:
Onset Date:
Rec V Date: 09/24/2021
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: ACHINESS; LOW GRADE FEVER; This spontaneous report received from a consumer and concerned a 67 year old female. The patient's height, and weight were not reported. The patient's concurrent conditions included: bundle branch block, post-traumatic stress disorder, and panic attacks. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: UNKNOWN) dose, start therapy date were not reported for prophylactic vaccination. The batch number was not reported and has been requested. Concomitant medications included acetylsalicylic acid for as a precaution for blood clots. On an unspecified date, the patient experienced achiness, and low grade fever. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the low grade fever and achiness was not reported. This report was non-serious. This case, from the same reporter is linked to 20210943927.

Other Meds: ASPIRIN [ACETYLSALICYLIC ACID]

Current Illness: Bundle branch block (heart condition, takes the heart a while to catch up before and after activities); Panic attacks; Post-traumatic stress disorder

ID: 1730189
Sex: M
Age:
State: CO

Vax Date:
Onset Date:
Rec V Date: 09/24/2021
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: EXPIRED DOSE ADMINISTERED; INCORRECT PRODUCT STORAGE; This spontaneous report received from a health care professional concerned a male of unspecified age. The patient's height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine (suspension for injection, route of admin not reported, batch number: 211A21A, expiry: 14-DEC-2021) dose, start therapy date were not reported for prophylactic vaccination. No concomitant medications were reported. On an unspecified date, the patient experienced expired dose administered, and incorrect product storage. The action taken with covid-19 vaccine was not applicable. The outcome of the incorrect product storage and expired dose administered was not reported. This report was non-serious.

Other Meds:

Current Illness:

ID: 1730190
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 09/24/2021
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: LOW TEMPERATURE; SLEPT OFF AN ON FOR ABOUT 24 HRS; CHILLS; LITTLE SICK ON STOMACH TUM HANDLE; CHEAPNESS ABOUT 4 HOURS; This spontaneous report received from a patient via a company representative concerned a patient of unspecified age and sex. The patient's height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown) dose, start therapy date were not reported for prophylactic vaccination. The batch number was not reported. The Company is unable to perform follow-up to request batch/lot number. No concomitant medications were reported. On an unspecified date, the patient experienced low temperature, slept off an on for about 24 hrs, chills, little sick on stomach tum handle, and cheapness about 4 hours. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from low temperature, slept off an on for about 24 hrs, chills, little sick on stomach tum handle, and cheapness about 4 hours. This report was non-serious.

Other Meds:

Current Illness:

ID: 1730191
Sex: U
Age:
State: CA

Vax Date:
Onset Date: 09/22/2021
Rec V Date: 09/24/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025J20-2A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: EXPIRED DOSE ADMINISTERED; OFF LABEL USE; This spontaneous report received from a health care professional concerned a patient of unspecified age and sex. The patient's height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine (suspension for injection, route of admin not reported, batch number: 205A21A and expiry: 21-SEP-2021) dose was not reported, administered on 22-SEP-2021 for prophylactic vaccination. No concomitant medications were reported. On 22-SEP-2021, the patient experienced expired dose administered. On 22-SEP-2021, the patient experienced off label use. The action taken with covid-19 vaccine was not applicable. The outcome of the off label use and expired dose administered was not reported. This report was non-serious.

Other Meds:

Current Illness:

ID: 1730192
Sex: F
Age:
State: KY

Vax Date:
Onset Date: 09/22/2021
Rec V Date: 09/24/2021
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: ADMINISTERED EXPIRED VACCINE; OFF LABEL USE; This spontaneous report received from a health care professional concerned 2 female patients. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine (suspension for injection, route of admin not reported, batch number: 201A21A expiry: 21-SEP-2021) dose was not reported, administered on 22-SEP-2021 for prophylactic vaccination. No concomitant medications were reported. On 22-SEP-2021, the patient experienced administered expired vaccine. On 22-SEP-2021, the patient experienced off label use. The action taken with covid-19 vaccine was not applicable. The outcome of the administered expired vaccine and off label use was not reported. This report was non-serious. This case, from the same reporter is linked to 20210944551.

Other Meds:

Current Illness:

ID: 1730193
Sex: F
Age:
State: TN

Vax Date:
Onset Date:
Rec V Date: 09/24/2021
Hospital:

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

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

Allergies:

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

Symptoms: LONGER MENSTRUAL PERIOD; CHEST PAIN; INCREASED HEART RATE; PAINFUL MENSTRUATION THAN USUAL; This spontaneous report received from a consumer concerned a female of unspecified age. The patient's height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown Expiry: unknown) dose, start therapy date were not reported for prophylactic vaccination. The batch number was not reported. Per procedure, no follow-up will be requested for this case. No concomitant medications were reported. On an unspecified date, the patient experienced longer menstrual period, chest pain, increased heart rate, and painful menstruation than usual. Laboratory data (dates unspecified) included: Heart rate (NR: not provided) increased. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the longer menstrual period, chest pain, increased heart rate and painful menstruation than usual was not reported. This report was non-serious.

Other Meds:

Current Illness:

ID: 1730194
Sex: F
Age:
State: MD

Vax Date:
Onset Date: 09/11/2021
Rec V Date: 09/24/2021
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: ADVERSE EVENT NOS; FEVER; This spontaneous report received from a patient concerned a 78 year old female. The patient's weight was 72.7 kilograms, and height was not reported. The patient's concurrent conditions included: primary pulmonary hypertension. The patient received macitentan (tablet, oral, batch number: ZE023B0301 expiry: 30-APR-2025) 10 mg, 1 time every 1 day, therapy dates were not reported for an unspecified indication. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin, and batch number were not reported) dose, start therapy date were not reported for prophylactic vaccination. The batch number was not reported and has been requested. Concomitant medications included warfarin sodium. On 11-SEP-2021, the patient experienced adverse event nos. On 11-SEP-2021, the patient experienced fever. Treatment medications (dates unspecified) included: acetylsalicylic acid. The action taken with covid-19 vaccine ad26.cov2.s was not applicable; and dose of macitentan was not changed. The outcome of the adverse event nos and fever was not reported. This report was non-serious.

Other Meds: COUMADIN

Current Illness: Primary pulmonary hypertension

ID: 1730195
Sex: M
Age:
State: TX

Vax Date:
Onset Date:
Rec V Date: 09/24/2021
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: ACHINESS; LOW GRADE FEVER; This spontaneous report received from a consumer concerned a 70 year old male. The patient's height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: UNKNOWN ) dose, start therapy date were not reported for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On an unspecified date, the patient experienced achiness, and low grade fever. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the low grade fever and achiness was not reported. This report was non-serious. This case, from the same reporter is linked to 20210943871.

Other Meds:

Current Illness:

ID: 1730196
Sex: U
Age:
State: WI

Vax Date:
Onset Date: 09/22/2021
Rec V Date: 09/24/2021
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: RECEIVED EXPIRED VACCINE; This spontaneous report received from a health care professional concerned a patient of unspecified age and sex. The patient's height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1808982, expiry: 21-SEP-2021) dose was not reported, administered on 22-SEP-2021 for prophylactic vaccination. No concomitant medications were reported. On 22-SEP-2021, the patient experienced received expired vaccine. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of received expired vaccine was not reported. This report was non-serious.

Other Meds:

Current Illness:

ID: 1730197
Sex: F
Age:
State: OK

Vax Date:
Onset Date: 09/22/2021
Rec V Date: 09/24/2021
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: RECEIVED AN EXPIRED DOSE OF THE JANSSEN COVID-19 VACCINE; This spontaneous report received from a health care professional concerned a female of unspecified age. The patient's height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, intramuscular, batch number: 203A21A, and expiry: 21-SEP-2021) dose was not reported, administered on 22-SEP-2021 for prophylactic vaccination. No concomitant medications were reported. On 22-SEP-2021, the patient experienced received an expired dose of the janssen covid-19 vaccine. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of received an expired dose of the janssen covid-19 vaccine was not reported. This report was non-serious. This case, from the same reporter is linked to 20210944792 and 20210943969.

Other Meds:

Current Illness:

ID: 1730198
Sex: F
Age:
State: KY

Vax Date:
Onset Date: 09/22/2021
Rec V Date: 09/24/2021
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: ADMINISTERED EXPIRED VACCINE; This spontaneous report received from a patient concerned a 47 year old female. The patient's height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 201A21A, and expiry: 21-SEP-2021) dose was not reported, administered on 22-SEP-2021 for prophylactic vaccination. No concomitant medications were reported. On 22-SEP-2021, the patient experienced administered expired vaccine. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of administered expired vaccine was not reported. This report was non-serious.

Other Meds:

Current Illness:

ID: 1730199
Sex: M
Age:
State: OK

Vax Date:
Onset Date: 09/22/2021
Rec V Date: 09/24/2021
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: EXPIRED VACCINE ADMINISTERED; This spontaneous report received from a health care professional concerned a male of unspecified age. The patient's height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, intramuscular, batch number: 203A21A, expiry: 21-SEP-2021) dose was not reported, administered on 22-SEP-2021 for prophylactic vaccination. No concomitant medications were reported. On 22-SEP-2021, the patient experienced expired vaccine administered. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of expired vaccine administered was not reported. This report was non-serious. This case, from the same reporter is linked to 20210944792 and 20210943966.

Other Meds:

Current Illness:

ID: 1730200
Sex: M
Age:
State: CA

Vax Date:
Onset Date: 06/22/2021
Rec V Date: 09/24/2021
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: 20210622; Test Name: Body temperature; Result Unstructured Data: 103 F

Allergies:

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

Symptoms: OFF LABEL USE; VACCINE RECEIVED AT HOME BY 17 YEARS OLD PATIENT; HEADACHE; FEVER; This spontaneous report received from a parent concerned a 17 year old male. The patient's height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine (suspension for injection, route of admin not reported, batch number: 201A21A, expiry: UNKNOWN) dose was not reported, administered on 22-JUN-2021 for prophylactic vaccination. No concomitant medications were reported. On 22-JUN-2021, the patient experienced off label use. On 22-JUN-2021, the patient experienced vaccine received at home by 17 years old patient. On 22-JUN-2021, the patient experienced headache. On 22-JUN-2021, the patient experienced fever. Laboratory data included: Body temperature (NR: not provided) 103 F. Treatment medications included: paracetamol. The action taken with covid-19 vaccine was not applicable. The patient recovered from headache, and fever on 23-JUN-2021, and the outcome of off label use and vaccine received at home by 17 years old patient was not reported. This report was non-serious.

Other Meds:

Current Illness:

ID: 1730201
Sex: F
Age:
State: KY

Vax Date:
Onset Date: 09/22/2021
Rec V Date: 09/24/2021
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: EXPIRED VACCINE ADMINISTERED; This spontaneous report received from a patient concerned a 20 year old female. The patient's height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine (suspension for injection, route of admin not reported, batch number: 201A21A expiry: 21-SEP-2021) dose was not reported, administered on 22-SEP-2021 for prophylactic vaccination. No concomitant medications were reported. On 22-SEP-2021, the patient experienced expired vaccine administered. The action taken with covid-19 vaccine was not applicable. The outcome of expired vaccine administered was not reported. This report was non-serious.

Other Meds:

Current Illness:

ID: 1730202
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 09/24/2021
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: HEART ISSUE; This spontaneous report received from a consumer via a company representative concerned a patient of unspecified age and sex. The patient's height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown) dose, start therapy date were not reported for prophylactic vaccination. The batch number was not reported. Per procedure, no follow-up will be requested for this case. No concomitant medications were reported. On an unspecified date, the patient experienced heart issue. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of heart issue was not reported. This report was non-serious. This case, from the same reporter is linked to 20210943837.

Other Meds:

Current Illness:

ID: 1730203
Sex: M
Age:
State: NC

Vax Date:
Onset Date: 09/22/2021
Rec V Date: 09/24/2021
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: SEVERE RIGHT SIDED LOWER BACK PAIN; This spontaneous report received from a parent concerned a 25 year old male. The patient's height, and weight were not reported. The patient's concurrent conditions included: no alcohol use, and non-smoker, and other pre-existing medical conditions included: The patient had no known allergies. The patient had no history of drug abuse or illicit drug use. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 207A21A, and expiry: 21-SEP-2021) dose was not reported, administered on 16-SEP-2021 for prophylactic vaccination. No concomitant medications were reported. On 22-SEP-2021, the patient experienced severe right sided lower back pain. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from severe right sided lower back pain. This report was non-serious.

Other Meds:

Current Illness: Abstains from alcohol; Non-smoker

ID: 1730204
Sex: F
Age:
State: OH

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

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

Lab Data:

Allergies:

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: DELAYED MENSTRUAL CYCLE; TIRED; BODY SORENESS; FEVER; This spontaneous report received from a patient concerned a 19 year old female. The patient's height, and weight were not reported. The patient's pre-existing medical conditions included: Patient had no change in lifestyle or medications. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 201A21A and expiry: 21-SEP-2021) dose was not reported, administered on 08-SEP-2021 for prophylactic vaccination. Concomitant medications included ethinylestradiol/norgestimate. On 08-SEP-2021, the patient experienced body soreness. On 08-SEP-2021, the patient experienced fever. On 09-SEP-2021, the patient experienced tired. On 21-SEP-2021, the patient experienced delayed menstrual cycle. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from body soreness, and fever on 09-SEP-2021, and had not recovered from tired, and delayed menstrual cycle. This report was non-serious.

Other Meds: TRI-SPRINTEC

Current Illness:

ID: 1730205
Sex: M
Age:
State: NJ

Vax Date:
Onset Date: 09/22/2021
Rec V Date: 09/24/2021
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: ADMINISTRATION OF EXPIRED VACCINE; This spontaneous report received from a health care professional concerned a 34 year old male. The patient's height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine (suspension for injection, route of admin not reported, batch number: 206A21A, and expiry: 21-SEP-2021) dose was not reported, administered on 22-SEP-2021 for prophylactic vaccination. No concomitant medications were reported. On 22-SEP-2021, the patient experienced administration of expired vaccine. The action taken with covid-19 vaccine was not applicable. The outcome of administration of expired vaccine was not reported. This report was non-serious.

Other Meds:

Current Illness:

ID: 1730206
Sex: F
Age:
State: VA

Vax Date:
Onset Date: 09/22/2021
Rec V Date: 09/24/2021
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: ADMINISTRATION OF AN EXPIRED VACCINE; This spontaneous report received from a consumer concerned a 63 year old female. The patient's height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine (suspension for injection, route of admin not reported, batch number: 206A21A, expiry: 21-SEP-2021) dose was not reported, administered on 22-SEP-2021 for prophylactic vaccination. No concomitant medications were reported. On 22-SEP-2021, the patient experienced administration of an expired vaccine. The action taken with covid-19 vaccine was not applicable. The outcome of administration of an expired vaccine was not reported. This report was non-serious.

Other Meds:

Current Illness:

ID: 1730207
Sex: M
Age:
State: WI

Vax Date:
Onset Date: 09/21/2021
Rec V Date: 09/24/2021
Hospital:

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

Lab Data: Test Name: Blood pressure; Result Unstructured Data: High

Allergies:

Symptom List: Nausea

Symptoms: HIGH BLOOD PRESSURE; DIFFICULTY BREATHING; DRY COUGH; PRESSURE ON CHEST (FELT LIKE SOMEONE WAS STANDING ON CHEST); This spontaneous report received from a patient concerned a 32 year old male. The patient's height, and weight were not reported. The patient's concurrent conditions included: alcohol user, and ex-smoker, and other pre-existing medical conditions included: The patient had no known drug allergies and no drug abuse or illicit drug use. The patient received covid-19 vaccine (suspension for injection, route of admin not reported, batch number: 205A21A, expiry: UNKNOWN) dose was not reported, administered on 08-JUN-2021 for prophylactic vaccination. No concomitant medications were reported. On 21-SEP-2021, the patient experienced pressure on chest (felt like someone was standing on chest). On 22-SEP-2021, the patient experienced difficulty breathing. On 22-SEP-2021, the patient experienced dry cough. On an unspecified date, the patient experienced high blood pressure. Laboratory data (dates unspecified) included: Blood pressure (NR: not provided) High. The action taken with covid-19 vaccine was not applicable. The outcome of the dry cough, difficulty breathing, pressure on chest (felt like someone was standing on chest) and high blood pressure was not reported. This report was non-serious.

Other Meds:

Current Illness: Alcohol use (It was and alcohol was around.); Ex-smoker (Was a smoker for quite a number of of years, smoked from age 17-29 and is 32 now.)

ID: 1730208
Sex: M
Age:
State: AZ

Vax Date:
Onset Date: 09/22/2021
Rec V Date: 09/24/2021
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: ADMINISTRATION OF EXPIRED VACCINE (ADMINISTERED VACCINE ON 22-SEP-2021 WHICH EXPIRED ON 21-SEP-2021); This spontaneous report received from a health care professional concerned multiple patients. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 202A21A, expiry: 21-SEP-2021) dose was not reported, administered on 22-SEP-2021 for prophylactic vaccination. No concomitant medications were reported. On 22-SEP-2021, the patient experienced administration of expired vaccine (administered vaccine on 22-sep-2021 which expired on 21-sep-2021). The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of administration of expired vaccine (administered vaccine on 22-sep-2021 which expired on 21-sep-2021) was not reported. This report was non-serious.

Other Meds:

Current Illness:

ID: 1730209
Sex: M
Age:
State: MN

Vax Date:
Onset Date: 09/22/2021
Rec V Date: 09/24/2021
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: EXPIRED DOSE GIVEN; This spontaneous report received from a consumer concerned a male of unspecified age. The patient's height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine (suspension for injection, route of admin not reported, batch number: 206A21A, expiry: 21-SEP-2021) dose was not reported, administered on 22-SEP-2021 for prophylactic vaccination. No concomitant medications were reported. On 22-SEP-2021, the patient experienced expired dose given. The action taken with covid-19 vaccine was not applicable. The outcome of expired dose given was not reported. This report was non-serious.

Other Meds:

Current Illness:

ID: 1730210
Sex: F
Age:
State: NJ

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

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011j20a
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data: Test Date: 202109; Test Name: CAT scan; Result Unstructured Data: Not Reported; Test Date: 202109; Test Name: Lab test; Result Unstructured Data: Not Reported; Test Date: 202109; Test Name: Blood test; Result Unstructured Data: Not Reported

Allergies:

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

Symptoms: SYMPTOMS OF HEADACHE; This spontaneous report received from a consumer concerned a female of unspecified age. The patient's height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown) dose was not reported, administered on 07-MAR-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On SEP-2021, Laboratory data included: Blood test (not provided) Not Reported, CAT scan (not provided) Not Reported, and Lab test (not provided) Not Reported. On 01-SEP-2021, the patient experienced symptoms of headache. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from symptoms of headache. This report was non-serious.

Other Meds:

Current Illness:

ID: 1730211
Sex: U
Age:
State: ND

Vax Date:
Onset Date: 09/22/2021
Rec V Date: 09/24/2021
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: ADMINISTRATION OF EXPIRED VACCINE; This spontaneous report received from a health care professional concerned a patient of unspecified age and sex. The patient's height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine (suspension for injection, route of admin not reported, batch number: 202A21A, and expiry: 21-SEP-2021) dose was not reported, administered on 22-SEP-2021 for prophylactic vaccination. No concomitant medications were reported. On 22-SEP-2021, the patient experienced administration of expired vaccine. The action taken with covid-19 vaccine was not applicable. The outcome of administration of expired vaccine was not reported. This report was non-serious.

Other Meds:

Current Illness:

ID: 1730212
Sex: M
Age:
State: MI

Vax Date:
Onset Date: 09/16/2021
Rec V Date: 09/24/2021
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: RASH AT GROIN AREA (INITIALLY IN MINOR AMOUNT, OINTMENT MADE IT WORSE); This spontaneous report received from a patient concerned an 81 year old male. The patient's height, and weight were not reported. The patient's concurrent conditions included: non alcohol user, non smoker, penicillin allergy, and sulfa allergy, and other pre-existing medical conditions included: The patient did not have any history of drug abuse or illicit drug use. The patient received covid-19 vaccine (suspension for injection, route of admin not reported, batch number: 042A21A, expiry: UNKNOWN) dose was not reported, administered on 14-SEP-2021 for prophylactic vaccination. No concomitant medications were reported. On 16-SEP-2021, the patient experienced rash at groin area (initially in minor amount, ointment made it worse). On 21-SEP-2021, treatment medications included: hydrocortisone. The action taken with covid-19 vaccine was not applicable. The patient was recovering from rash at groin area (initially in minor amount, ointment made it worse). This report was non-serious.

Other Meds:

Current Illness: Abstains from alcohol; Non-smoker; Penicillin allergy; Sulfonamide allergy

ID: 1730213
Sex: F
Age:
State: OR

Vax Date:
Onset Date: 09/22/2021
Rec V Date: 09/24/2021
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: ADMINISTRATION OF EXPIRED VACCINE; This spontaneous report received from a health care professional concerned a 19 year old female. The patient's height, and weight were not reported. The patient's pre-existing medical conditions included: The patient had no known allergies and the patient was doing well and did not have any adverse event. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 202A21A, expiry: 21-SEP-2021) dose was not reported, administered on 22-SEP-2021 for prophylactic vaccination. No concomitant medications were reported. On 22-SEP-2021, the patient experienced administration of expired vaccine. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of administration of expired vaccine was not reported. This report was non-serious. This case, from the same reporter is linked to 20210944784.

Other Meds:

Current Illness:

ID: 1730214
Sex: M
Age:
State: TN

Vax Date:
Onset Date:
Rec V Date: 09/24/2021
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: FATIGUE; LIGHT HEADACHE; This spontaneous report received from a consumer concerned a 40 year old male. The patient's height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown) dose, start therapy date were not reported for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On an unspecified date, the patient experienced fatigue, and light headache. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from fatigue, and light headache. This report was non-serious.

Other Meds:

Current Illness:

ID: 1730215
Sex: M
Age:
State: SC

Vax Date:
Onset Date: 09/02/2021
Rec V Date: 09/24/2021
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: CONTINUAL INTENSE TINNITUS; This spontaneous report received from a patient concerned a 54 year old male. The patient's height, and weight were not reported. The patient's concurrent conditions included: abstains from alcohol, and non smoker, and other pre-existing medical conditions included: The patient had no known allergies and no drug abuse/illicit drug use. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 204A21A expiry: 21-SEP-2021) dose was not reported, administered on 01-SEP-2021 for prophylactic vaccination. No concomitant medications were reported. On 02-SEP-2021, the patient experienced continual intense tinnitus. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from continual intense tinnitus. This report was non-serious.

Other Meds:

Current Illness: Abstains from alcohol; Non-smoker

ID: 1730216
Sex: M
Age:
State: OK

Vax Date:
Onset Date: 09/22/2021
Rec V Date: 09/24/2021
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: ADMINISTRATION OF EXPIRED VACCINE; This spontaneous report received from a health care professional concerned a male of unspecified age. The patient's height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine (suspension for injection, intramuscular, batch number: 203A21A, expiry: 21-SEP-2021) dose was not reported, administered on 22-SEP-2021 for prophylactic vaccination. No concomitant medications were reported. On 22-SEP-2021, the patient experienced administration of expired vaccine. The action taken with covid-19 vaccine was not applicable. The outcome of administration of expired vaccine was not reported. This report was non-serious. This case, from the same reporter is linked to 20210943966 and 20210943969.

Other Meds:

Current Illness:

ID: 1730217
Sex: U
Age:
State: CT

Vax Date:
Onset Date: 09/22/2021
Rec V Date: 09/24/2021
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: ADMINISTRATION OF EXPIRED VACCINE; This spontaneous report received from a health care professional concerned a patient of unspecified age and sex. The patient's height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine (suspension for injection, route of admin not reported, batch number: 201A21A, and expiry: 21-SEP-2021) dose was not reported, administered on 22-SEP-2021 for prophylactic vaccination. No concomitant medications were reported. On 22-SEP-2021, the patient experienced administration of expired vaccine. The action taken with covid-19 vaccine was not applicable. The outcome of administration of expired vaccine was not reported. This report was non-serious.

Other Meds:

Current Illness:

ID: 1730218
Sex: F
Age:
State: CT

Vax Date:
Onset Date: 04/01/2021
Rec V Date: 09/24/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Pain in extremity

Symptoms: SIGNIFICANT IRREGULARITY IN MENSURAL CYCLES AND IRREGULAR VISCOUS BLEEDING; ALTERED MENSTRUAL CYCLE; This spontaneous report received from a patient concerned a female of unspecified age. The patient's height, and weight were not reported. The patient's concurrent conditions included: birth control. The patient received covid-19 vaccine (suspension for injection, route of admin not reported, batch number: Unknown) dose was not reported, administered on APR-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On APR-2021, the patient experienced significant irregularity in mensural cycles and irregular viscous bleeding. On APR-2021, the patient experienced altered menstrual cycle. The action taken with covid-19 vaccine was not applicable. The outcome of the significant irregularity in mensural cycles and irregular viscous bleeding and altered menstrual cycle was not reported. This report was non-serious.

Other Meds:

Current Illness: Birth control (Patient had not got period in years due to taking birth control)

ID: 1730219
Sex: F
Age:
State: VA

Vax Date:
Onset Date: 09/22/2021
Rec V Date: 09/24/2021
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: ADMINISTRATION OF AN EXPIRED VACCINE; This spontaneous report received from a consumer concerned a 71 year old female. The patient's height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 206A21A, and expiry: 21-SEP-2021) dose was not reported, administered on 22-SEP-2021 for prophylactic vaccination. No concomitant medications were reported. On 22-SEP-2021, the patient experienced administration of an expired vaccine. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of administration of an expired vaccine was not reported. This report was non-serious. This case, from the same reporter is linked to 20210944245.

Other Meds:

Current Illness:

ID: 1730220
Sex: M
Age:
State:

Vax Date:
Onset Date: 09/21/2021
Rec V Date: 09/24/2021
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: VACCINE WAS STORED PAST RECOMMENDED STORAGE CONDITIONS AFTER PUNCTURE; 1 DOSE OF VACCINE THAT WAS STORED PAST RECOMMENDED STORAGE CONDITIONS ADMINISTERED; OFF LABEL USE; This spontaneous report received from a health care professional concerned a 60 year old male. The patient's height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine (suspension for injection, route of admin not reported, batch number: 207A21A and expiry: UNKNOWN) dose was not reported, administered on 21-SEP-2021 for prophylactic vaccination. No concomitant medications were reported. On 21-SEP-2021, the patient experienced vaccine was stored past recommended storage conditions after puncture. On 21-SEP-2021, the patient experienced 1 dose of vaccine that was stored past recommended storage conditions administered. On 21-SEP-2021, the patient experienced off label use. The action taken with covid-19 vaccine was not applicable. The outcome of the vaccine was stored past recommended storage conditions after puncture, 1 dose of vaccine that was stored past recommended storage conditions administered and off label use was not reported. This report was non-serious.

Other Meds:

Current Illness:

ID: 1730221
Sex: F
Age: 45
State: FL

Vax Date: 09/03/2021
Onset Date: 09/03/2021
Rec V Date: 09/24/2021
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: 2021; Test Name: blood pressure; Result Unstructured Data: 180/103 mmHg; Test Date: 2021; Test Name: fever; Result Unstructured Data: 100.3 degrees Fahrenheit

Allergies:

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

Symptoms: Vaccination adverse reaction; chills; fever of 100.3 degrees Fahrenheit; pain on the left shoulder joint; panic attack; blood pressure is 180/103; This spontaneous case was reported by a consumer and describes the occurrence of PANIC ATTACK (panic attack), BLOOD PRESSURE INCREASED (blood pressure is 180/103), VACCINATION COMPLICATION (Vaccination adverse reaction), CHILLS (chills) and PYREXIA (fever of 100.3 degrees Fahrenheit) in a 45-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 was reported. Concomitant products included ALPRAZOLAM (XANAX) for an unknown indication. On 03-Sep-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 03-Sep-2021, the patient experienced PANIC ATTACK (panic attack), BLOOD PRESSURE INCREASED (blood pressure is 180/103), CHILLS (chills), PYREXIA (fever of 100.3 degrees Fahrenheit) and ARTHRALGIA (pain on the left shoulder joint). On an unknown date, the patient experienced VACCINATION COMPLICATION (Vaccination adverse reaction). At the time of the report, PANIC ATTACK (panic attack), BLOOD PRESSURE INCREASED (blood pressure is 180/103), VACCINATION COMPLICATION (Vaccination adverse reaction), CHILLS (chills), PYREXIA (fever of 100.3 degrees Fahrenheit) and ARTHRALGIA (pain on the left shoulder joint) had resolved. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): In 2021, Blood pressure measurement: 80/103 mmhg (High) 180/103 mmHg. In 2021, Body temperature: 100.3 (High) 100.3 degrees Fahrenheit. 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 to the events not reported. The patient reported "I called my insurance nurse line and was allowed to take my anxiety meds". Most recent FOLLOW-UP information incorporated above includes: On 08-Sep-2021: Follow up contains updated event outcomes.

Other Meds: XANAX

Current Illness:

ID: 1730222
Sex: F
Age: 25
State:

Vax Date: 03/24/2021
Onset Date: 07/01/2021
Rec V Date: 09/24/2021
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: Patient thinks she caught either the Delta Variance or COVID-19; 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 EXPOSURE TO SARS-COV-2 (Patient thinks she caught either the Delta Variance or COVID-19) in a 25-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. Unknown) for COVID-19 vaccination. No medical history was provided by the reporter. On 24-Mar-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. In July 2021, the patient experienced EXPOSURE TO SARS-COV-2 (Patient thinks she caught either the Delta Variance or COVID-19). At the time of the report, EXPOSURE TO SARS-COV-2 (Patient thinks she caught either the Delta Variance or COVID-19) outcome was unknown.

Other Meds:

Current Illness:

ID: 1730223
Sex: M
Age: 54
State: FL

Vax Date: 02/04/2021
Onset Date: 08/24/2021
Rec V Date: 09/24/2021
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: Sore arm; Sweaty; Headache, less severe; Fever, less severe; Had a full third dose of the Moderna vaccine and they are not immunocompromised; Had a full third dose of the Moderna vaccine; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (Sore arm), HYPERHIDROSIS (Sweaty), HEADACHE (Headache, less severe), PYREXIA (Fever, less severe) and EXTRA DOSE ADMINISTERED (Had a full third dose of the Moderna vaccine and they are not immunocompromised) in a 55-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 04-Feb-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 24-Aug-2021, received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 24-Aug-2021, the patient experienced EXTRA DOSE ADMINISTERED (Had a full third dose of the Moderna vaccine and they are not immunocompromised). 24-Aug-2021, the patient experienced INCORRECT DOSE ADMINISTERED (Had a full third dose of the Moderna vaccine). On 25-Aug-2021, the patient experienced PAIN IN EXTREMITY (Sore arm), HYPERHIDROSIS (Sweaty), HEADACHE (Headache, less severe) and PYREXIA (Fever, less severe). The patient was treated with IBUPROFEN (ADVIL [IBUPROFEN]) on 25-Aug-2021 for Adverse event, at an unspecified dose and frequency. On 26-Aug-2021, PAIN IN EXTREMITY (Sore arm), HYPERHIDROSIS (Sweaty), HEADACHE (Headache, less severe) and PYREXIA (Fever, less severe) had resolved. At the time of the report, EXTRA DOSE ADMINISTERED (Had a full third dose of the Moderna vaccine and they are not immunocompromised) and INCORRECT DOSE ADMINISTERED (Had a full third dose of the Moderna vaccine) outcome was unknown. The consumer stated that he had a full third dose of the Moderna vaccine and he was not immunocompromised. The consumer stated that the onset of symptoms was the day after getting the shot and lasted for a day after the third dose. The consumer stated that he took Advil as a treatment medication after the first 24 hours. No concomitant product use was provided by the reporter. This case was linked to MOD-2021-309106 (Patient Link).

Other Meds:

Current Illness:

ID: 1730224
Sex: F
Age: 63
State: MI

Vax Date: 03/20/2021
Onset Date: 03/20/2021
Rec V Date: 09/24/2021
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: the pain localization varies in the arm (after second dose); pain from the shoulder all the way down into the hand (after second dose); Tired for a week (after first dose); This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (the pain localization varies in the arm (after second dose)), FATIGUE (Tired for a week (after first dose)) and ARTHRALGIA (pain from the shoulder all the way down into the hand (after second dose)) in a 66-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 007B21A) for COVID-19 vaccination. No medical history provided. Concomitant products included DULOXETINE HYDROCHLORIDE, LISINOPRIL DIHYDRATE (LISINOPRIL [LISINOPRIL DIHYDRATE]), AMLODIPINE BESILATE, OMEPRAZOLE SODIUM (OMEPRAZOLE [OMEPRAZOLE SODIUM]), FAMOTIDINE (FAMOTIDINE ACID REDUCER), HYDROXYZINE HYDROCHLORIDE (HYDROXYZINE [HYDROXYZINE HYDROCHLORIDE]), METOPROLOL SUCCINATE, GABAPENTIN, MONTELUKAST, ALPRAZOLAM (XANAX SR), VITAMIN C [ASCORBIC ACID] and CALCIUM for an unknown indication. On 20-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 20-Mar-2021, the patient experienced FATIGUE (Tired for a week (after first dose)). On an unknown date, the patient experienced PAIN IN EXTREMITY (the pain localization varies in the arm (after second dose)) and ARTHRALGIA (pain from the shoulder all the way down into the hand (after second dose)). The patient was treated with PARACETAMOL (TYLENOL) at an unspecified dose and frequency. At the time of the report, PAIN IN EXTREMITY (the pain localization varies in the arm (after second dose)) and ARTHRALGIA (pain from the shoulder all the way down into the hand (after second dose)) outcome was unknown and FATIGUE (Tired for a week (after first dose)) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Concomitant medication butrotion-HclXl tab 300mg 1/night is used. This case was linked to MOD-2021-314900.

Other Meds: DULOXETINE HYDROCHLORIDE; LISINOPRIL [LISINOPRIL DIHYDRATE]; AMLODIPINE BESILATE; OMEPRAZOLE [OMEPRAZOLE SODIUM]; FAMOTIDINE ACID REDUCER; HYDROXYZINE [HYDROXYZINE HYDROCHLORIDE]; METOPROLOL SUCCINATE; GABAPENTIN; MONTELUKAST; XANAX SR; VIT

Current Illness:

ID: 1730225
Sex: F
Age: 55
State: UT

Vax Date: 08/25/2021
Onset Date: 08/29/2021
Rec V Date: 09/24/2021
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: shooting pain from shoulder down to hand; rash is inflamed; shooting pain from shoulder down to hand; developed a rash on her left arm extending from arm to elbow and upto shoulder; This spontaneous case was reported by a pharmacist and describes the occurrence of PAIN IN EXTREMITY (shooting pain from shoulder down to hand), INFLAMMATION (rash is inflamed), RASH (developed a rash on her left arm extending from arm to elbow and upto shoulder) and ARTHRALGIA (shooting pain from shoulder down to hand) in a 55-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 002F21A) for COVID-19 vaccination. No Medical History information was reported. On 25-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 29-Aug-2021, the patient experienced RASH (developed a rash on her left arm extending from arm to elbow and upto shoulder). On an unknown date, the patient experienced PAIN IN EXTREMITY (shooting pain from shoulder down to hand), INFLAMMATION (rash is inflamed) and ARTHRALGIA (shooting pain from shoulder down to hand). The patient was treated with SULFAMETHOXAZOLE, TRIMETHOPRIM (BACTRIM DS) at an unspecified dose and frequency and DIPHENHYDRAMINE HYDROCHLORIDE (BENADRYL [DIPHENHYDRAMINE HYDROCHLORIDE]) at an unspecified dose and frequency. At the time of the report, PAIN IN EXTREMITY (shooting pain from shoulder down to hand), INFLAMMATION (rash is inflamed) and ARTHRALGIA (shooting pain from shoulder down to hand) outcome was unknown and RASH (developed a rash on her left arm extending from arm to elbow and upto shoulder) had not 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. Patient used Ice for treatment medication. No Concomitant medication has been provided by reporter.

Other Meds:

Current Illness:

ID: 1730226
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 09/24/2021
Hospital:

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

Lab Data: Test Date: 20210908; Test Name: SARS-CoV-2 test; Test Result: Positive ; Result Unstructured Data: Type of test- Not rapid Sample- Nasal

Allergies:

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

Symptoms: After virus, we waited for no symptoms to get second vaccine. Are now miserable with symptoms exactly like we have virus again; shortness of breath; cough; Diarrhea; chills; Muscle ache; Headache; Fever; This spontaneous case was reported by a patient and describes the occurrence of SUSPECTED COVID-19 (After virus, we waited for no symptoms to get second vaccine. Are now miserable with symptoms exactly like we have virus again), DYSPNOEA (shortness of breath), COUGH (cough), DIARRHOEA (Diarrhea) and CHILLS (chills) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 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 SUSPECTED COVID-19 (After virus, we waited for no symptoms to get second vaccine. Are now miserable with symptoms exactly like we have virus again), DYSPNOEA (shortness of breath), COUGH (cough), DIARRHOEA (Diarrhea), CHILLS (chills), MYALGIA (Muscle ache), HEADACHE (Headache) and PYREXIA (Fever). At the time of the report, SUSPECTED COVID-19 (After virus, we waited for no symptoms to get second vaccine. Are now miserable with symptoms exactly like we have virus again), DYSPNOEA (shortness of breath), COUGH (cough), DIARRHOEA (Diarrhea), CHILLS (chills), MYALGIA (Muscle ache), HEADACHE (Headache) and PYREXIA (Fever) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 08-Sep-2021, SARS-CoV-2 test: positive (Positive) Type of test- Not rapid Sample- Nasal. No concomitant medication information provided by the reporter. No treatment information provided. Patients was also having abdominal pain. This case was linked to MOD-2021-315854 (Patient Link). Reporter did not allow further contact Most recent FOLLOW-UP information incorporated above includes: On 14-Sep-2021: Significant Follow up received on 14 sep 2021 contains new events: fever, chills, shortness of breath, cough, muscle ache, headache, diarrhea.

Other Meds:

Current Illness:

ID: 1730227
Sex: F
Age: 33
State: CA

Vax Date: 12/24/2020
Onset Date: 01/23/2021
Rec V Date: 09/24/2021
Hospital:

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

Lab Data: Test Name: Heart rate; Result Unstructured Data: Heart rate elevated to 145 - 150 (When attempting to go upstairs)

Allergies:

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

Symptoms: Intermittent Tachycardia; Shortness of Breath; Chest discomfort; Slept for 12 hours straight/Unable to get out of bed; Became very fatigued; Had headache; This spontaneous case was reported by a consumer and describes the occurrence of TACHYCARDIA (Intermittent Tachycardia), DYSPNOEA (Shortness of Breath), CHEST DISCOMFORT (Chest discomfort), FEELING ABNORMAL (Slept for 12 hours straight/Unable to get out of bed) and FATIGUE (Became very fatigued) in a 34-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 042L20A and 037K20A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. Concurrent medical conditions included Allergy to antibiotic (Amoxicillin) and Exercise induced asthma since February 2000. Concomitant products included CURCUMA LONGA (TURMERIC [CURCUMA LONGA]) and PROBIOTICS NOS for an unknown indication. On 24-Dec-2020, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 23-Jan-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 23-Jan-2021, the patient experienced TACHYCARDIA (Intermittent Tachycardia), DYSPNOEA (Shortness of Breath), CHEST DISCOMFORT (Chest discomfort), FEELING ABNORMAL (Slept for 12 hours straight/Unable to get out of bed), FATIGUE (Became very fatigued) and HEADACHE (Had headache). At the time of the report, TACHYCARDIA (Intermittent Tachycardia), DYSPNOEA (Shortness of Breath) and FEELING ABNORMAL (Slept for 12 hours straight/Unable to get out of bed) had resolved and CHEST DISCOMFORT (Chest discomfort), FATIGUE (Became very fatigued) and HEADACHE (Had headache) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, Heart rate: 145 (High) Heart rate elevated to 145 - 150 (When attempting to go upstairs). For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. Lab investigations included: Troponin, Sedimentation rate, CBC, CMP and also Echocardiogram, Holter monitor- Where all the results were in their normal ranges Other concomitant medications include: Mushroom immune booster which are taken orally Treatment information was not reported This case was linked to MOD-2021-010602 (Patient Link).

Other Meds: TURMERIC [CURCUMA LONGA]; PROBIOTICS NOS

Current Illness: Allergy to antibiotic (Amoxicillin); Exercise induced asthma

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am