VAERS 2021 Database www.vaers.hhs.gov

Main Page | All 2021 Deaths | Videos
VAERS Updated: 10/01/2021
** VAERS DATABASE Last updated: October 1, 2021**
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Manufacturers

Total Manufacturer
187,133MODERNA
33,878JANSSEN
2,321PFIZER\BIONTECH
1,091GLAXOSMITHKLINE BIOLOGICALS
983UNKNOWN MANUFACTURER
363MERCK & CO. INC.
229SEQIRUS, INC.
45DYNAVAX TECHNOLOGIES CORPORATION
41NOVARTIS VACCINES AND DIAGNOSTICS
29SANOFI PASTEUR
18EMERGENT BIOSOLUTIONS
8PAXVAX
7TEVA PHARMACEUTICALS
4PFIZER\WYETH
3BERNA BIOTECH, LTD.
2SMITHKLINE BEECHAM
2INTERCELL AG
2PROTEIN SCIENCES CORPORATION
1CSL LIMITED

Incidents per State

State Total
77,548
AK1,869
AL5,581
AR3,688
AS47
AZ14,288
CA61,984
CO11,665
CT8,149
DC1,663
DE1,807
FL37,749
FM5
GA15,058
GU120
HI2,453
IA4,625
ID2,692
IL20,334
IN24,007
KS4,615
KY7,696
LA4,887
MA14,654
MD12,514
ME3,129
MH11
MI18,739
MN12,528
MO9,710
MP29
MS2,790
MT2,375
NC16,368
ND1,356
NE2,880
NH3,100
NJ17,634
NM3,916
NV4,239
NY34,355
OH19,081
OK6,195
OR8,636
PA23,083
PR2,370
QM2
RI2,088
SC6,411
SD1,212
TN9,131
TX35,174
UT4,273
VA14,937
VI64
VT1,676
WA14,909
WI11,259
WV2,388
WY861
XB5
XL1
XV2

ID: 1040630
Sex: F
Age: 59
State: MS

Vax Date: 02/11/2021
Onset Date: 02/17/2021
Rec V Date: 02/19/2021
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: Ether

Symptom List: Dysphagia, Epiglottitis

Symptoms: Moderate pain at injection site. for 3 days. Injection site very swollen for 3 days. Very sleepy for 2 days. Swollen Neck Lymph node on left side of neck noticed on Wednesday, February 18. Swelling much worse Thursday Februarys 19, late evening. Noticed bruising on lower stomach Thursday Feb. 19. I have no income and no money to go to the doctor to have these checked out. Do you know where I can get some money to have my lymph node checked out and to have a blood platelet test? Thank you. I might die from not getting the blood platelet test.

Other Meds: None

Current Illness: None

ID: 1040631
Sex: F
Age: 29
State: HI

Vax Date: 02/17/2021
Onset Date: 02/18/2021
Rec V Date: 02/19/2021
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: Celery, Mango, Rabbits

Symptom List: Anxiety, Dyspnoea

Symptoms: 2/18/2021 4:30am woke up nauseous, having muscle aches from injection site in left bicep to top of head on same side, not able to think clearly ?foggy?. 1:30pm having muscle aches in both sides of neck and headache left sided

Other Meds: Kyleena IUD, Sertraline, Trazodone, Women?s Multivitamin

Current Illness: Migraine days prior to vaccination

ID: 1040632
Sex: M
Age: 67
State: ID

Vax Date: 02/01/2021
Onset Date: 02/06/2021
Rec V Date: 02/19/2021
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: NKA

Symptom List: Chest discomfort, Dysphagia, Pain in extremity, Visual impairment

Symptoms: Transient and intermittant twitching and minor tearing of left eye.

Other Meds: naprosyn 200 mg, x 2, Vitamen D 4000mg po qd , Adderall 5 mg po, the day before vaccination

Current Illness: Enlarged prostate and related symptoms

Date Died: 02/06/2021

ID: 1040633
Sex: F
Age: 52
State: CA

Vax Date: 01/30/2021
Onset Date: 02/06/2021
Rec V Date: 02/19/2021
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: Death due to hemorrhagic stroke.

Other Meds: Levothyroxine 100mcg, one tablet daily

Current Illness:

ID: 1040634
Sex: F
Age: 39
State: HI

Vax Date: 01/13/2021
Onset Date: 02/11/2021
Rec V Date: 02/19/2021
Hospital:

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

Lab Data:

Allergies: N/A

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

Symptoms: Injection site arm pain, headache, grabbing low back pain first on 2/11, resolved on 2/13. Then repeated on 2/16 with injection site arm pain followed by back pain & headache. Arm pain gone on 2/18, but back pain and headache persisting.

Other Meds: NuvaRing MVI

Current Illness: N/A

ID: 1040635
Sex: F
Age: 66
State: WA

Vax Date: 02/02/2021
Onset Date: 02/17/2021
Rec V Date: 02/19/2021
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: allergic to dust mites

Symptom List: Chills, Confusional state, Eye inflammation, Headache, Laboratory test

Symptoms: Two weeks after the first vaccine had a large circular red area appear around the area of the shot. The area was tender, especially at the injection spot. The red area was large like three inches by two inches. sometimes solid red and sometimes just a big ring. It lasted several days. Unusual in that it appeared two weeks after.

Other Meds: asthma inhaler

Current Illness: had a slight cold right before vaccination and after it

ID: 1040636
Sex: F
Age: 71
State: MD

Vax Date: 02/17/2021
Onset Date: 02/17/2021
Rec V Date: 02/19/2021
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: Moderna COVID-19 Vaccine EUA Site of injection increasingly sore. Unable to sleep. Chilled the morning after the injection. Continued to increase in soreness through the next day. Unable to sleep next night. Took 500 mg acetaminophen at 1 am, 2/19/21. Still sore.

Other Meds: Azmacort, Relaxifene, Vagifem, Montelukast, vitamin d, DHEA, Flonase

Current Illness:

ID: 1040637
Sex: M
Age: 33
State:

Vax Date: 02/12/2021
Onset Date: 02/12/2021
Rec V Date: 02/19/2021
Hospital:

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

Lab Data:

Allergies: Seasonal allergies only.

Symptom List: Pharyngeal swelling

Symptoms: Severe soreness at injection site, lasting about 24 hours.

Other Meds: None.

Current Illness: None.

ID: 1040638
Sex: F
Age: 50
State: CA

Vax Date: 01/23/2021
Onset Date: 01/31/2021
Rec V Date: 02/19/2021
Hospital:

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

Lab Data:

Allergies: penicillin, codeine

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: On Sunday, Jan 31, 2021 I woke up around noon after working a graveyard shift and wasn't feeling right. There was a pressure in my head, along with sinus and ear pain and a fuzzy feeling in my face. By Monday, Feb, 1, 2021, the pain was worse now with a fatigued feeling after sleeping 20 of the last 24 hours. I went to my Dr on 2/1/2021 and recognized a slide on the left side of my face. From my forehead not wrinkling up the same as right side, left eye wasn't closing as tight and the left cheek and side of mouth were sliding. He said it was Bells Palsy. He prescribed 10 days of prednisone and an antivirus medicine to be taken 3 times a day. That week I slept a lot and wasn't able to sit up much due to the head pain and the lightening bolt feeling in my face. By the 2nd week I was able to sit up more, but still very tired/fatigued. I was off work for 2 weeks, returning to work on 2/14/2021. There is still a slight slide on the left side in the eye and cheek.

Other Meds: Celebrex, Claritin

Current Illness: none

ID: 1040639
Sex: M
Age: 23
State: AZ

Vax Date: 02/18/2021
Onset Date: 02/19/2021
Rec V Date: 02/19/2021
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: None

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Chills described as ?internally cold,? uncontrollable shaking, fever, body aches, light headache onset 14 hours after second vaccine dose administered. Woke up from sleeping with these symptoms. Shaking discontinued after taking vitamin C, zinc, and Tylenol.

Other Meds: Ibuprofen

Current Illness: None

ID: 1040640
Sex: M
Age: 29
State: CA

Vax Date: 02/18/2021
Onset Date: 02/18/2021
Rec V Date: 02/19/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Vaccination site erythema, Vaccination site pruritus, Vaccination site swelling

Symptoms: Sudden bloody nose a little less than 2 hours after the shot and it away pretty quickly.

Other Meds: Qvar inhaler 80mcg

Current Illness: None

ID: 1040641
Sex: F
Age: 66
State: NC

Vax Date: 02/18/2021
Onset Date: 02/18/2021
Rec V Date: 02/19/2021
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: Oxybutinin- dry mouth cracked lips, Trospium CL- dry mouth, Myrbetric, Sulfa

Symptom List: Rash, Urticaria

Symptoms: Pfizer, dizzyness, sore injection site, fast heart rate

Other Meds: Baclofen 10mg tab/day, Bipropion XL 150mg/day, Toviaz 4mg tab/day, Rituxan infusion q6 mths, Bioflavanoid/c,, Calcium Aspertate Anhydrous, D-liq, K27,Milk Thistle, Enzymes for meals, Probiotic, Stinging Nettles, Turmeric caps

Current Illness: have MS, CLL

ID: 1040642
Sex: F
Age: 34
State:

Vax Date: 01/09/2021
Onset Date: 01/16/2021
Rec V Date: 02/19/2021
Hospital:

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

Lab Data:

Allergies: Penicillin

Symptom List: Blood pressure decreased, Chest pain, Chills, Confusional state, Decreased appetite

Symptoms: 3 hours after injection: Sore arm (where injected). Symptoms faded within 24 hours. 7 days after the injection: a large (~3" diameter) raised circular red spot appeared at the injection site. It was itchy but painless. It disappeared 36-48 hours after it began. Not other side effects were noted.

Other Meds: Synthroid

Current Illness:

ID: 1040643
Sex: F
Age: 34
State:

Vax Date: 02/09/2021
Onset Date: 02/10/2021
Rec V Date: 02/19/2021
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: Penicillin

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

Symptoms: 2 hours after injection: sore arm. Relief within 24 hours 12 hours after injection: mild headache lasting 12 hours

Other Meds: Synthroid

Current Illness:

ID: 1040644
Sex: F
Age: 67
State: OH

Vax Date: 02/18/2021
Onset Date: 02/19/2021
Rec V Date: 02/19/2021
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: Fish

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

Symptoms: Fever Chills Aches

Other Meds: Amlodipine Besylate 5 MG Synthroid 75 MCG Calcium

Current Illness:

ID: 1040645
Sex: F
Age: 75
State: MA

Vax Date: 02/15/2021
Onset Date: 02/17/2021
Rec V Date: 02/19/2021
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: none

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

Symptoms: On Feb. 15th after injection - which hurt when I was given shot, Arm was sore and swollen which is normal. Developed fever,chills tiredness,on Feb. 16th. On Feb. 17th. Arm was sore and quite itchy. Noticed a round red blotch about size of half dollar and assumed this was normal. The itching has become worse and the red blotch has spread more on arm . Today it was very itchy and used cortisone cream which helped for about 2 hours and them became itchy again. . i looked on line they called it Covid Arm. I will contact my Doctor on Monday if this does not go away.

Other Meds: Tylenol, Centrum Silver, Vitamin B6, Vitamin D 100n units,Vitamin C 1000 mg. Losartan 100 Mg., Hydrochlorothorozide 12 1/2 mg.and Amlodopine 5 mg.

Current Illness: none

ID: 1040646
Sex: F
Age: 35
State: NY

Vax Date: 02/18/2021
Onset Date: 02/18/2021
Rec V Date: 02/19/2021
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: shellfish, latex, gluten intolerance. Have had prior anaphylactic reaction to MMR vaccine, other vaccines seem to be fine.

Symptom List: SARS-CoV-2 antibody test, SARS-CoV-2 test negative

Symptoms: About 2 hours after injection tongue started swelling, became difficult to breath, mouth and throat started tingling, started blacking out. Chewed 2 benadryl and went to emergency room. Was given more antihistamines there and monitored until reaction stopped.

Other Meds: None

Current Illness: None

ID: 1040647
Sex: M
Age: 40
State: AZ

Vax Date: 02/18/2021
Onset Date: 02/18/2021
Rec V Date: 02/19/2021
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: Fever, chills, body aches, headache

Other Meds:

Current Illness:

ID: 1040648
Sex: F
Age: 73
State: DE

Vax Date: 01/24/2021
Onset Date: 01/28/2021
Rec V Date: 02/19/2021
Hospital:

Vax Type: PNC13
Manufacturer: PFIZER\WYETH
Vax Name: PNEUMO (PREVNAR13)
Lot:
Dose Series: UNK
Vax Route:
Vax Site: LG

Lab Data:

Allergies: prednisone

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: several days after vaccine I developed a bitter taste in my mouth which persists now, almost a month later. It has affected my appetite, everything tastes bad. I am treating it with salt water rinses.

Other Meds: Incruse ellipse inhaler, atorvastatin, baby aspirin, vit D3, premarin, protea, omeprazole

Current Illness: complex migraine.

ID: 1040649
Sex: F
Age: 42
State: PA

Vax Date: 02/02/2021
Onset Date: 02/03/2021
Rec V Date: 02/19/2021
Hospital:

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

Lab Data:

Allergies: Cilantro, avocado, mustard, seasonal and environmental

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

Symptoms: Full body Hives, swollen feet and hands

Other Meds: Synthroid

Current Illness: None

ID: 1040650
Sex: M
Age: 68
State:

Vax Date: 02/15/2021
Onset Date: 02/16/2021
Rec V Date: 02/19/2021
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: 24 hours after vaccination - moderate muscular and joint pain, mild headache, mild arm pain at injection site 48 hours after vaccination - moderate joint and muscular pain, mild headache, mild fatigue 72 hours after vaccination - mild joint and muscular pain, moderate fatigue, diarrhea, nausea, mild ear pressure (worst overall day after vaccination) 88 hours after vaccination - feeling much better as symptoms listed above have dissipated

Other Meds:

Current Illness:

ID: 1040672
Sex: F
Age: 55
State: NY

Vax Date: 12/01/2019
Onset Date:
Rec V Date: 02/19/2021
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: preseptal cellulitis/facial cellulitis; flu likesyndrome; This case was reported by a physician via call center representative and described the occurrence of preseptal cellulitis in a 55-year-old female patient who received Herpes zoster (Shingrix) for prophylaxis. In December 2019, the patient received the 1st dose of Shingrix. In December 2019, less than 2 weeks after receiving Shingrix and an unknown time after starting Augmentin, the patient experienced preseptal cellulitis (serious criteria GSK medically significant) and influenza-like symptoms. The patient was treated with amoxicillin sodium, potassium clavulanate (Augmentin) and sulfamethoxazole + trimethoprim (Bactrim). In January 2020, the outcome of the preseptal cellulitis and influenza-like symptoms were recovered/resolved. The reporter considered the preseptal cellulitis and influenza-like symptoms to be almost certainly related to Shingrix. Additional details were provided as follows: The patient experienced typical moderate flu like symptom within first day (24 to 48 hrs) of receiving Shingrix. The patient developed left facial cellulitis, treated some 5 to10 days after vaccination. The patient treated successfully with combination of PO Bactrim and Augmentin for 10 Days. The patient never suffered preseptal cellulitis before. The patient recovered and hesitantly agreed to a second dose. For tolerance of 2nd dose please refer case US2021AMR032306.; Sender's Comments: US-GLAXOSMITHKLINE-US2021AMR032306:Same reporter

Other Meds:

Current Illness:

ID: 1040673
Sex: F
Age:
State: OH

Vax Date: 01/28/2021
Onset Date: 01/28/2021
Rec V Date: 02/19/2021
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: laid on the floor and does not know if passed out on the floor or fell asleep (thinks could not have fallen asleep with such a pain); horrible pain on left side (side of the injection); awful pain on left leg; could not raise leg; congestion in head, like a sinus infection; tiredness/fatigue; Headache; Chills; A spontaneous report was received from a consumer, a 79-year-old female patient, who received Moderna's COVID-19 Vaccine (mRNA-1273) and experienced laid on the floor and does not know if passed out on the floor or fell asleep (thinks could not have fallen asleep with such a pain), horrible pain on left side (side of the injection), headache, chills, tiredness/fatigue, awful pain in leg, could not raise leg, and congestion in head, like a sinus infection. The patient's medical history was not provided. Her allergies included sulfa, mycin, meloxicam and glycopyrrolate. Concomitant medications included blood pressure medication (name not reported). On 28 Jan 2021, approximately one day prior to the onset of events, the patient received her first of two planned doses of mRNA-1273 (Batch number: 028L20A) on the left side (anatomical location not reported) for prophylaxis of COVID-19 infection. On 28 Jan 2021, on the night of the vaccination, the patient woke up with a horrible pain one her left side (side of the injection), headache, chills, fatigue/tiredness, an awful pain on her leg, and congestion in her head, like a sinus infection. She got up thinking that walking would make the pain on her leg go away, but it did not. When the patient tried to go back to bed, she could not raise her leg so she laid on the floor and she did not know if she passed out on the floor or fell asleep (she thought she could not have fallen asleep with such pain). When the patient woke up, she could move her leg normally. Treatment information was not provided. Action taken in response to the events was unknown. The events, laid on the floor and does not know if passed out on the floor or fell asleep (thinks could not have fallen asleep with such a pain), horrible pain on left side (side of the injection), headache, chills, awful pain in leg, could not raise leg, and congestion in head, like a sinus infection were considered resolved on 29 Jan 2021. The event, fatigue/tiredness was considered not recovered/not resolved.; Reporter's Comments: This case concerns a 79 year old female subject, who experienced a serious unexpected event of loss of consciousness after first dose of mRNA1273 (Lot# 028L20A). Based on the current available information and temporal association between the use of the product and the start date of the event, a causal relationship cannot be excluded. Further information has been requested.

Other Meds:

Current Illness: Allergy to antibiotic (mycin); Drug hypersensitivity (Robinul); Drug hypersensitivity (Mobic); Sulfonamide allergy

ID: 1040674
Sex: M
Age:
State: NY

Vax Date: 01/29/2021
Onset Date:
Rec V Date: 02/19/2021
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: Completely lost hearing; Scratchy throat; A spontaneous report was received from a consumer (patient's wife), concerning an 80 years-old male patient, unknown race and ethnicity, who received Moderna's COVID-19 vaccine (mRNA-1273), and experienced completely lost hearing and scratchy throat". The patient's medical history included had partial hearing loss before the Moderna dose. Concomitant medications reported included were losartan, pantoprazole, unspecified prostate medication, cholesterol medication, heart disease, and arrhythmia medication. On 29 Jan 2021, prior to the onset of events, the patient received their first of two planned doses of mRNA-1273 (batch number: 012L20A), administered in the left arm for the prophylaxis of COVID-19 infection. On an unknown date, the patient experienced scratchy throat and completely lost hearing (had partial hearing loss before the Moderna dose) and was beginning to hear a bit. The patient did not take any medication to treat symptoms. The consumer was very much concerned because of hearing loss and asked if patient should receive the second dose of Moderna vaccine. Action taken with second dose of mRNA-1273 in response to the events was not reported. The outcome of the events completely lost hearing is resolving and scratchy throat were reported as unknown.; Reporter's Comments: Very limited information regarding the reported events has been provided at this time. onset duration is lacking for the events Further information has been requested.

Other Meds: LOSARTAN; PANTOPRAZOLE

Current Illness:

ID: 1040675
Sex: F
Age: 29
State: TX

Vax Date: 02/03/2021
Onset Date: 02/03/2021
Rec V Date: 02/19/2021
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: Arm is sore at the injection site; Had thoughts of killing myself; Had a psychotic episode; A spontaneous report was received from a consumer concerning a 29-years-old, female patient who received Moderna's COVID-19 Vaccine (mRNA-1273) and experienced psychotic episode and arm is sore at the injection site. The patient's medical history was not provided. Concomitant product use was not provided by the reporter. On 03 Feb 2021, prior to the onset of the symptoms, the patient received their first of two planned doses of mRNA-1273 [Lot number 013M20A] intramuscularly in the left arm for prophylaxis of COVID-19 infection. On 03 Feb 2021, the patient experienced a psychotic episode after the vaccination in which she had thoughts of killing herself and other people. Treatment information was not provided. She reported that it happened once before in March 2020 when her epilepsy medication was not at the correct dose. On 04 Feb 2021, the patient reported that her arm was sore at the injection site. Action taken with mRNA-1273 in response to the events was not provided. The outcome of the events psychotic episode and arm is sore at the injection site was unknown.; Reporter's Comments: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.

Other Meds:

Current Illness:

ID: 1040676
Sex: F
Age:
State: MA

Vax Date: 02/04/2021
Onset Date: 02/04/2021
Rec V Date: 02/19/2021
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: Some fluid leaked on arm; Some fluid leaked on arm; A spontaneous report was received from a physician, concerning herself, a 42-year-old, female patient who received Moderna's COVID-19 vaccine (mRNA-1273) and some fluid leaked on arm. The patient's medical history was not provided. Concomitant product use was not provided by the reporter. On an unspecified date, the patient received their first of two planned doses of mRNA-1273 (Batch number not provided). On 04 Feb 2021, the patient received their second of two planned doses of mRNA-1273 (Batch number: 028L20A) intramuscularly in the left arm for prophylaxis of COVID-19 infection and some fluid leaked on her arm. No treatment information was provided. The patient received both scheduled doses of mRNA-1273 prior to the event; therefore, action taken with the drug in response to the event is not applicable. The event, some fluid leaked on her arm, was considered resolved on 04 Feb 2021.; Reporter's Comments: This report refers to a case of product administration error for mRNA-1273 (Batch number: 028L20A). There was no associated AEs with this case of inappropriate dose administered and exposure via skin.

Other Meds:

Current Illness:

ID: 1040677
Sex: F
Age: 16
State: PA

Vax Date: 01/28/2021
Onset Date: 01/28/2021
Rec V Date: 02/19/2021
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: Had very mild pain in left arm; 16 year old daughter injected with Moderna vaccine; A spontaneous report was received from a consumer, concerning a 16-year-old female patient, who received Moderna's COVID-19 vaccine, where 16-year-old daughter injected with Moderna vaccine had very mild pain in left arm. The patient's medical history reported included severe asthma. Concomitant product use was not provided by the reporter. On 28 JAN 2021, prior to the onset of event, the patient received their first of two planned doses of mRNA-1273 (lot number unknown) intramuscularly in the left arm for prophylaxis of COVID-19 infection. On 28 JAN 2021, a 16-year-old patient was injected with vaccine and had no reactions of fever or any other adverse events. Later, on an unspecified date in 2021, she also experienced very mild pain in her left arm where she was vaccinated. The patient was under asthma medications twice a day for her asthma. Action taken with mRNA-1273 in response to the events were not reported. The outcome of the event, 16-year-old daughter injected with Moderna vaccine was considered resolved on 28 JAN 2021. The outcome of the event had very mild pain in left arm was considered unknown at the time of this report.; Reporter's Comments: The events developed on same day after first dose of mRNA-1372. Based on the current available information and temporal association between the use of the product and the start date of the event of vaccination site pain, a causal relationship cannot be excluded.

Other Meds:

Current Illness: Asthma (Severe asthma.)

ID: 1040678
Sex: M
Age: 73
State: TX

Vax Date: 01/12/2021
Onset Date: 01/12/2021
Rec V Date: 02/19/2021
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: Partial dose administrated; Pain at injection site; A spontaneous report was received from a consumer, concerning a 73-year-old male patient, who received Moderna's COVID-19 vaccine and experienced pain at injection site and also informed about partial dose administrated. The patient medical history was not provided. Concomitant product use was not provided by the reporter. On 12 Jan 2021, prior to the onset of event, the patient received their first of two planned dose of mRNA-1273 (Batch Number 205L20A ) for prophylaxis of COVID-19 infectious route intramuscular and experienced pain at injection site from 12 Jan 2021 to 16 Jan 2021. Patient was informed to self-administer acetaminophen. On 05 Feb 2021, the patient reported his second dose of two planned dose of mRna- 1273 (Batch Number 043L20A) for prophylaxis of COVID-19 infectious route intramuscular. During the second dose he reportedly only received a partial dose. Action taken with mRNA-1273 in response to the event pain at injection site was no change in dose. Action taken with mRNA-1273 in response to the event partial dose administrated was not reported. The outcome of event, pain at injection site was considered unknown at the time of this report. The outcome of event partial dose administrated was considered resolved on 05 Feb 2021.; Reporter's Comments: This report refers to a case of incorrect dose administered for mRNA-1273. Based on the current available information and temporal association between the use of the product and the start date of the event of vaccination site pain, a causal relationship cannot be excluded.

Other Meds:

Current Illness:

ID: 1040679
Sex: F
Age: 63
State: WA

Vax Date: 01/07/2021
Onset Date: 01/07/2021
Rec V Date: 02/19/2021
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: second injection subcutaneous; second injection lump injections site; Half the dose leaked out of the arm; second injection red injection site; first injection fever; first injection sore arm; A spontaneous report was received from a physician regarding his wife, a 63-year-old female patient who received Moderna's COVID-19 vaccine (mRNA-1273) and experienced the injection was given subcutaneously instead of intramuscularly/product administration error, about half of the vaccine leaked out onto her arm/accidental underdose, and lump and redness at injection site/injection site erythema and mass. The patient's medical history included fever and arm discomfort after first dose. Treatment for these conditions were not reported. No other medical history or concomitant medications were discussed. On 07 Jan 2021, prior to onset of events the patient received the FIRST of two planned doses of mRNA-1273 (Lot number: 041L20A) intramuscularly for prophylaxis of COVID-19 infection. Reactions included fever and arm soreness. On 04 Feb 2021, prior to the onset of the events, the patient received the SECOND of two doses of mRNA-1273 (Lot number: 41L20A) SUBCUTANEOUSLY for prophylaxis of COVID-19 infection. On 04 Feb 2021, as the vaccine was being administered, the physician (husband) noticed that the medical assistant gave the dose subcutaneously instead of intramuscularly and about half the dose leaked out. Action taken with mRNA-1273 was unknown. The outcome of the events, injection not given intramuscularly/product administration error, about half of the vaccine leaked out onto her arm/accidental underdose, and lump and redness at injection site/injection site erythema and mass, were considered resolved.; Reporter's Comments: This case concerns a 63 year old, female patient, who experienced a few non-serious events. Based on the current available information and temporal association between the use of the product and the start date of the event, a causal relationship cannot be excluded. This report also refers to a case of inappropriate route of product administration and accidental underdose for mRNA-1273, lot # 041L20A with no associated AEs. Further information has been requested.

Other Meds:

Current Illness:

ID: 1040680
Sex: F
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 02/19/2021
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: Allergies to medications, food, or other; Initial information was received on 26-Jan-2021 regarding an unsolicited valid non-serious case from a other health professional This case involves an adult female patient who experienced allergies to medications, food, or other, while she received INFLUENZA VACCINE. Medical history, medical treatment, vaccination, concomitant medication and family history were not provided. On an unknown date, the patient received a dose of suspect INFLUENZA VACCINE produced by unknown manufacturer [lot number and expiry date not reported] via an unknown route at an unknown administration site for prophylactic vaccination. On an unknown date, the patient developed a non-serious allergies to medications, food, or other (hypersensitivity) unknown latency following the administration of INFLUENZA VACCINE. Details of laboratory data were not reported. It was not reported if the patient received a corrective treatment. At the time of reporting, the event outcome is unknown. There will be no information on batch number for this case.

Other Meds:

Current Illness:

ID: 1040681
Sex: F
Age: 20
State:

Vax Date: 02/01/2021
Onset Date: 02/01/2021
Rec V Date: 02/19/2021
Hospital:

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

Lab Data:

Allergies: Penicillin, Bactrim

Symptom List: Injection site pain

Symptoms: Hives on both shoulders, swelling of both arms, pounding heart.

Other Meds: Sprintec, Viibryd

Current Illness:

ID: 1040682
Sex: F
Age: 65
State: FL

Vax Date: 02/15/2021
Onset Date: 02/16/2021
Rec V Date: 02/19/2021
Hospital:

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

Lab Data:

Allergies: Keflix

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

Symptoms: Intense pain in arm couldn't lift it past horizontal plain; 102 fever, headache, chills, sweating, fatigue. Needed prescription pain med for arm pain..otc were ineffective

Other Meds: Synthroid ; Vitamin B, Vitamin C

Current Illness: None

ID: 1040683
Sex: M
Age: 64
State: NY

Vax Date: 02/10/2021
Onset Date: 02/18/2021
Rec V Date: 02/19/2021
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: Profonol

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

Symptoms: Yesterday the site of the injection started to itch, it is red and irritated and my shoulder hurt.

Other Meds: Advanced Blood Pressure Formula and Vit D3 gummies

Current Illness: None

ID: 1040684
Sex: F
Age: 67
State: FL

Vax Date: 02/02/2021
Onset Date: 02/04/2021
Rec V Date: 02/19/2021
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: hot red rash on upper arm, spread down the arm , along side of right breast and into the arm pit . Swollen arm with Pain and and itchy. Went to urgent care on 2/5 was diagnosed with cellulitis infection, given steroids and antibiotic for 10 days. On the 9th day severe pain developed in the arm, and neck. I went to Chiropractor on 2/15/2021thinking I had a pinched nerve. On 2/16/2021 I developed a new rash on my right arm. On 2/17/2021 I saw my PCP who diagnosed me with shingles. I am currently being treated with anitviral and paib medication. They felt my immune system had been weakened by the vaccine, then the infection which may have caused the immune system to react with shingles.

Other Meds:

Current Illness:

ID: 1040685
Sex: M
Age: 65
State: VA

Vax Date: 01/29/2021
Onset Date: 01/29/2021
Rec V Date: 02/19/2021
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: None

Symptom List: Erythema, Pruritus

Symptoms: One hour after the vaccine I experienced loss of sensation of my left cheek from under my eye to my mouth. My wife noted loss of muscle tone of my cheek and inability to smile on the left side. Symptoms started about one hour after the injection and resolved after three hours.

Other Meds: Enalipril/Hydrochlorothiazide Metformin Jardiance Lipitor Aspirin

Current Illness: None

ID: 1040686
Sex: F
Age: 52
State: WI

Vax Date: 02/17/2021
Onset Date: 02/17/2021
Rec V Date: 02/19/2021
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: N/A

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

Symptoms: At 9:30 that evening I started throwing up, terrible chills I couldn?t get warm even under my electric blanket and featherbed, my muscles were spasming, my joints hurt like never before with stabbing pains, the headache was worse than the worst migraine I ever had, it hurts to open my eyelids even in the dark , I literally thought I was dying from the 2nd shot.

Other Meds: Escitalopram, rosuvastatin, hydroxyzinr

Current Illness: None

ID: 1040687
Sex: F
Age: 46
State: MD

Vax Date: 02/17/2021
Onset Date: 02/18/2021
Rec V Date: 02/19/2021
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: None

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

Symptoms: Had 2nd shot , went to bed with muscle pain that evening around 10pm. Woke up the next morning with swollen top lip. The next morning my cheeks were swollen. These sites is where I have had filler also. Allergan and Metz products have been injected in top lip and cheek areas. Also Botox.

Other Meds: Lexapro

Current Illness: None

ID: 1040688
Sex: F
Age: 27
State: NY

Vax Date: 02/18/2021
Onset Date: 02/18/2021
Rec V Date: 02/19/2021
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: Intense headache by 430pm Arm soreness by 3pm Intense Chills and body aches by 2am

Other Meds:

Current Illness:

ID: 1040689
Sex: F
Age: 40
State: PA

Vax Date: 01/23/2021
Onset Date: 01/30/2021
Rec V Date: 02/19/2021
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: n/a

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

Symptoms: One week after the first dose of the Moderna COVID-19 vaccination, the injection spot on my right arm became very itchy. Afterwards, a pinkish-red rash developed on my arm and lasted for three days.

Other Meds: Omega-3 Fish Oil- 640mg, Whole-Food Multivitamin, Vitamin D3- 1, 250mg

Current Illness: n/a

ID: 1040690
Sex: F
Age: 58
State: PR

Vax Date: 02/16/2021
Onset Date: 02/17/2021
Rec V Date: 02/19/2021
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: pepper

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

Symptoms: besides the symptoms that I mentioned before, now I have a intense pain in the axilla of the injected arm. is very painful and it doesn't improve

Other Meds: none

Current Illness: none

ID: 1040691
Sex: M
Age: 44
State: NC

Vax Date: 02/16/2021
Onset Date: 02/16/2021
Rec V Date: 02/19/2021
Hospital:

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

Lab Data:

Allergies: Darvocet, Sulfa

Symptom List: Pain in extremity

Symptoms: severe migraine, panic attack, sweats, chills, nausea, ocular aura most side effects lasted about 14 hours, completely miserable.

Other Meds: Omeprazole, Meloxicam, Tramadol, Multivitamin

Current Illness: none

ID: 1040692
Sex: F
Age: 53
State: SC

Vax Date: 02/18/2021
Onset Date: 02/18/2021
Rec V Date: 02/19/2021
Hospital:

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

Lab Data:

Allergies: Influenza Vaccine (Fever, Swelling of upper limb); Vancomycin (Rash)

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

Symptoms: Vital signs: 124/74 right arm, HR 75, Pulse ox room air 99% Patient presented for 1st dose of COVID-19 Pfizer Vaccine. Post vaccination patient noted left arm pain to elbow and left supraclavicular swelling moving laterally. Noted tingling and pain then swelling in left neck/shoulder area. About size of a baseball. Patient given option to take benadryl 25 mg once before leaving or take it later if she is not improving. She prefers to take it now. Benadryl 25 mg PO x1 given at 1715 self-administered. Patient monitored for a total 40 minutes before being released. History of reaction to flu vaccination that resulted in arm swelling and high fever ~30 years ago. Vancomycin life threatening reaction.

Other Meds:

Current Illness:

ID: 1040693
Sex: F
Age: 70
State: OH

Vax Date: 02/17/2021
Onset Date: 02/18/2021
Rec V Date: 02/19/2021
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: Simvastatin's, penicillin, codeine

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

Symptoms: Right upper arm pain at a 9 on scale of 1 to 10 woke me up at 12:40 AM 2/18/2021. at 6:00 AM took 1,000 mg of Tylenol for pain brought it to a 3 if I didn't move arm. Continued at a level 7 on 2/19/2021 at 5:30 AM too 500 mg Tylenol and at 6:00 AM took another 500 mg. Pain continues now at 7:17 am at a level 2. 2/18/2021 diarrhea began about 8:00 am and continued until about 11:00 am. It wasn't severe but between the two side effects I could not go to work .

Other Meds: Pantoprazole sod dr 20 mg, Loratadine 8 10 mg, melatonin 5mg, Tylenol PM 1 tablet, vit D, 2,000 IU, B complex

Current Illness: Had mastectomy 12/16; no follow up treatment or medication required

ID: 1040694
Sex: M
Age: 41
State: NY

Vax Date: 02/08/2021
Onset Date: 02/08/2021
Rec V Date: 02/19/2021
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: none

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

Symptoms: Initial adverse events: night sweats, fever, body aches, muscle aches (Back pain). These all occurred about 12 hours after the second shot and subsided around 36 hours after the second shot. 8.5 days after the second shot I had throat and chest pain. This pain then continued and got worse to the point I went to the ER and was evaluated for potential heart attack. After testing - results were that I did not have a heart attack. I was still experiencing this pain, so the ER took a strep test. This was also negative. The diagnosis was "pulled chest muscle". I've had pulled muscles, I know what those feel like and it sure didn't feel like what I experienced on the night of the 16th and the day of the 17th of Feb. 2021.

Other Meds: none

Current Illness: no

ID: 1040695
Sex: M
Age: 50
State: GA

Vax Date: 02/17/2021
Onset Date: 02/17/2021
Rec V Date: 02/19/2021
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: Penicillin

Symptom List: Vomiting

Symptoms: An hour after 2nd dose, I experienced atrial fibrillation for the first time ever.

Other Meds: Olmesartan Omeprazole

Current Illness: None

ID: 1040696
Sex: F
Age: 57
State: OH

Vax Date: 02/11/2021
Onset Date: 02/13/2021
Rec V Date: 02/19/2021
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: macrobid

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: large hives/welts over left leg, right leg(thigh surface), abdomen, left side neck.

Other Meds: levothyroxine

Current Illness: none

ID: 1040697
Sex: M
Age: 69
State: IN

Vax Date: 02/18/2021
Onset Date: 02/19/2021
Rec V Date: 02/19/2021
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: None

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

Symptoms: Slight soreness in left arm at injection site. No OTC treatment taken and soreness is minor and manageable.

Other Meds: None

Current Illness: None

ID: 1040698
Sex: M
Age: 56
State:

Vax Date: 02/09/2021
Onset Date: 02/10/2021
Rec V Date: 02/19/2021
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: Patient described headache at night for multiple days in a row. Most recently on 2/17/21 patient reported felt headaches at night every night since date of vaccination.

Other Meds:

Current Illness:

ID: 1040699
Sex: F
Age: 78
State: KY

Vax Date: 02/14/2021
Onset Date: 02/14/2021
Rec V Date: 02/19/2021
Hospital:

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

Lab Data:

Allergies: Clarithromycin; Morphine; Nickel

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

Symptoms: 1st Vaccine 2/14/21; same day onset RLQ ABD pain with nausea and vomiting; seen at ED on 2/19/21 for ongoing symptoms; d/c'd home from ED same day to follow up with primary care as outpatient. Dx in ED: 1. Acute abdominal pain in right lower quadrant 2. Non-intractable vomiting with nausea, unspecified vomiting type

Other Meds:

Current Illness:

ID: 1040700
Sex: F
Age: 26
State: IL

Vax Date: 02/18/2021
Onset Date: 02/18/2021
Rec V Date: 02/19/2021
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: None

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

Symptoms: Chills beginning around 8:30pm the evening of receiving the vaccine, followed by fatigue, insomnia, headache, low grade fever, and muscle aches

Other Meds: Fluvoxamine, Novalog Insulin, Vitamin D, Vitamin C, Probiotic, Magnesium, Levothyroxine, Phentermine

Current Illness: None

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm