VAERS 2021 Database www.vaers.hhs.gov

Main Page | All 2021 Deaths | Videos
VAERS Updated: 11/12/2021
** VAERS DATABASE Last updated: November 12, 2021**
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Manufacturers

Total Manufacturer
46,870MODERNA
532GLAXOSMITHKLINE BIOLOGICALS
353PFIZER\BIONTECH
231MERCK & CO. INC.
221UNKNOWN MANUFACTURER
62SEQIRUS, INC.
25DYNAVAX TECHNOLOGIES CORPORATION
13EMERGENT BIOSOLUTIONS
12SANOFI PASTEUR
9NOVARTIS VACCINES AND DIAGNOSTICS
5PFIZER\WYETH
5PAXVAX
2TEVA PHARMACEUTICALS
2PROTEIN SCIENCES CORPORATION
1BERNA BIOTECH, LTD.
1INTERCELL AG
1CSL LIMITED

COVID19 Lot Number

VAX LOT Total
2S9CL1,906
1,575
289
IMM209286
252
236
229
s029456178
171
UT7065MA166
155
149
145
S034636133
107
U62828AA103
100
98
P10025327596
U6737AA85
UJ446AA79
78
78
59
57
4BH3254
4F47253
52
27656352
50
PP9L548
49TM346
42
40
38
MENVEO38
4F47237
R1B252M36
34
C5763AA30
93362229
25
300057A24
UNK24
22
CW311621
18
17
15
UH894AB15
3Y7NL12
R1B743M12
EJ168611
el128410
10
10
10
9
ARBA141A9
UNK9
8
UNK8
8
1F4EB8
Unknown7
7
No batch number6
5
5
UJ090AA5
5
5
4
4
4
UNK4
JEV18K95E4
UNK3
A115A3
Z127A3
3
3333324181073
2
2
2
TAR352
1
1
1
1
1
A739081
1
1
1
1
1
037K20A68,542
EL128447,700
133

Incidents per State

State Total
15,185
CA14,096
NY7,507
TX7,196
FL6,939
IN5,527
PA4,560
IL4,179
OH4,054
AZ3,856
MI3,771
NJ3,411
MA3,278
VA3,208
NC3,114
WA3,034
GA2,864
MD2,652
MN2,534
CO2,532
WI2,457
MO2,029
OR1,943
TN1,715
CT1,693
KY1,603
OK1,226
AL1,201
KS1,162
IA1,157
SC1,106
NM1,065
UT973
AR951
LA945
NE829
NV797
ME795
MT789
NH756
ID674
AK661
WV661
PR650
MS585
HI536
RI510
VT441
SD361
ND356
DE350
DC239
WY209
GU32
AS16
VI13
MP9
MH3
FM2
QM1
XB1

ID: 1064653
Sex: M
Age: 79
State: CA

Vax Date: 02/28/2021
Onset Date: 03/01/2021
Rec V Date: 03/02/2021
Hospital:

Lab Data: None

Allergies: Sulpha and Penincillin

Symptoms: Blood Blister in the mouth in the left cheek which burst with blood in mouth.

Other Meds: CARVEDILOL 12.5 MG, 3 TABLETS PER DAY, ONE each after B-Fast, Lunch and Dinner. PLAVIX 75 MG, 0NE TABLET/DAY - MORNING CRESTOR 20MG ONE TABLET IN AFTERNOON ASPRIN 81MG ONE TABLET - MORNING

Current Illness: None

ID: 1064654
Sex: F
Age: 24
State:

Vax Date: 02/26/2021
Onset Date: 02/28/2021
Rec V Date: 03/02/2021
Hospital:

Lab Data:

Allergies: No

Symptoms: Arm turned red and itchy and getting worse by the hour. Area appears to be a perfect obtuse angle and not a random shape.

Other Meds: Birth control

Current Illness: No

ID: 1064655
Sex: F
Age: 77
State: MD

Vax Date: 02/17/2021
Onset Date: 02/26/2021
Rec V Date: 03/02/2021
Hospital:

Lab Data: None

Allergies: Penicillin. Sulfa. Raw fruits and vegetables

Symptoms: 6 inch red raised red patch that itched and pained so far for 5 days. It is not at site of injection but in the inner crease of my elbow. I used ice and benydrel.

Other Meds: Effexor. Zoloft xyzal. 81mg aspirin. Letrozol. Cosentyx. Caltrate. Centrium. Vitamin D3.

Current Illness: None

ID: 1064657
Sex: F
Age: 87
State: AZ

Vax Date: 01/31/2021
Onset Date: 02/01/2021
Rec V Date: 03/02/2021
Hospital:

Lab Data: None

Allergies: Sulfa

Symptoms: Hallucinations in the last month or so, mostly when waking up after falling asleep during the day. Just occurred after getting the first shot and have happened sporadically over the last month or so.

Other Meds: Multivitamin, calcium, cranberry tablets, escitalopram, levothyroxine, lisinopril, metoprolol tartrate, ocuvite, sumvastatin, vitamin d3, warfarin

Current Illness:

ID: 1064658
Sex: F
Age: 30
State: CO

Vax Date: 02/27/2021
Onset Date: 02/28/2021
Rec V Date: 03/02/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Fatigue (began noticing 8 hours after injection, slept a lot), body aches (20 hours after), chills (20-24 hours after), fever (24-28 hours after). Symptoms continued until I took Tylenol following night (33 hours after injection). Pain/soreness at injection site almost immediately + swollen left underarm lymph nodes noticeable 40+ hours after. Tenderness and bruise-like pain there.

Other Meds: Prenatal vitamin, magnesium supplement, vitamin D supplement, fish oil, ashwaghanda, garlic oil, coq10, super B complex, joint supplement (move free ultra), milk thistle/tumeric, and baby aspirin.

Current Illness:

ID: 1064659
Sex: F
Age: 68
State: CA

Vax Date: 03/01/2021
Onset Date: 03/01/2021
Rec V Date: 03/02/2021
Hospital:

Lab Data:

Allergies:

Symptoms: The vaccinating nurse brought it to my attention that she thought that the vaccination site was too high. When I caught up to the patient and observed the site it was too high and was at the level of the humeral head. I informed the patient that this was higher than we would like and to notify me if there were any unusual symptoms hereafter. I gave her my contact information for follow up.

Other Meds:

Current Illness:

ID: 1064660
Sex: F
Age: 32
State: CO

Vax Date: 02/11/2021
Onset Date: 02/23/2021
Rec V Date: 03/02/2021
Hospital:

Lab Data: N/a just monitoring by doctor over the phone

Allergies: N/a

Symptoms: Almost 2 weeks lost vaccine was fighting cold woke up with painful armpit . Swollen lymph node in right armpit ( injection was in right arm ) . For about 18 hours had pain and discomfort . Next day still swollen and painful and less discomfort . Took about 4-5 days to go away fully . Used Ibuprofen and warm compress as advices by doctor. Was really scared thinking it?s related to my breast .

Other Meds: Birth control pills

Current Illness: Had cold symptoms starting from 2/15 and still runny nose , congestion when side effect started

ID: 1064661
Sex: F
Age: 80
State: MA

Vax Date: 02/11/2021
Onset Date: 02/15/2021
Rec V Date: 03/02/2021
Hospital: Y

Lab Data: CT Scan, MRI, Echo cardiogram, You'd have to speak with the doctors for others and dates

Allergies: none

Symptoms: My mother had a seizure on February 15th after recieving the moderna vaccine on February 11th within four days of the vaccine. Doctors at hospital. Staff cannot answer what caused the seizure though they found a 4mm bleed on her brain; believed unrelated to seizure; on an MRI. My mother has never had a seizure and noone in my family have had seizures. I don't know if it's related to the vaccine but felt it should be reported to you.

Other Meds: Folic acid, valsartan, amplodapine, sertreline, tylenol,

Current Illness: Primary Progressive Aphasia

ID: 1064662
Sex: F
Age: 41
State: TX

Vax Date: 02/15/2021
Onset Date: 03/01/2021
Rec V Date: 03/02/2021
Hospital:

Lab Data:

Allergies: Iodine

Symptoms: Arm, red swollen, itching, raised

Other Meds: Blood medicine

Current Illness: None

ID: 1064663
Sex: F
Age: 28
State: AK

Vax Date: 02/27/2021
Onset Date: 02/28/2021
Rec V Date: 03/02/2021
Hospital:

Lab Data:

Allergies: Allergic to apples, strawberries, birch tree pollen

Symptoms: at 8am on 02/28/2021 I woke up in pain, feeling tired and sick. All of my skin, back and spine hurt, in the way that your body is sensitive and extra painful when you have a fever but I checked and I haven't had a fever yet. All of the day on 02/28/2021 I experienced skin and back pain, headache, fatigue, and brain fog (difficulty focusing and making decisions) as well as swollen and tender lymph nodes in my left armpit and under the left side of my jaw. On 03/01/2021 I woke up and felt better in the morning, I went for a walk around 3 pm and around 4 pm when I got back and sat down I started to experience headache, severe nausea which turned into chest pain and chest tightness and I still have swollen lymph nodes.

Other Meds:

Current Illness:

ID: 1064664
Sex: F
Age: 56
State: VA

Vax Date: 02/25/2021
Onset Date: 02/28/2021
Rec V Date: 03/02/2021
Hospital:

Lab Data:

Allergies: Several antibiotics Iv dye Iodine

Symptoms: Besides the usual fever, aches, fatigue I have hives like rash on my right upper arm near first injection. Very very itchy

Other Meds: Multi-vitamin, calciumk, organic sulfur, immune 6, singular, metformin, celexa,

Current Illness: Allergies

ID: 1064665
Sex: M
Age: 30
State: CA

Vax Date: 03/01/2021
Onset Date: 03/01/2021
Rec V Date: 03/02/2021
Hospital:

Lab Data:

Allergies:

Symptoms: COVID19 VACINE CLINIC SHCE: 3/1/2021 4:57 pm: 1st Seizure 20 sec long 30 year old male, had a seizure 10 mins after receiving 1st dosage of pfizer. History of Seizures per parents that are accompanying the patient, every 4 days. Dx of Epilepsy. 3 RN's attending 1. FIRST RN 2. SECOND RN 3. THIRD RN MA attending: 1. ATTENDING MA Note: First Vitals taken, 10 mins after 1st dosage of Pfizer given. 5:00 pm: BP:147/82 HR: 74 O2: 96% Notes: No complaints of pain 5:07 pm: BP: 125/73 HR:76 O2:96 Notes: No complaints of pain Outcome: 30 mins in Observation area, 2nd Dosage for Pfizer appointment made for Hospital. 5:17 pm: 2nd Seizure 10 sec long 5:19pm: EMS called by NP 5:19pm: BP:140/71 P: 69 O2: 96 5:24 pm: EMS Arrived 5:31 pm: Vitals BP:115/72 P:87 O2: 97 Outcome: Family refused EMS. EMS released the patient to the parents due to history of epilepsy at 5:33pm, patient stable. **Instructions were given to the parents by Charge RN and atttending RN, advised the family to take the patient to the ER if symptoms worsen. Family understood and agreed. 5:34 pm patient was able to walk out with parent to the exit. Director, & RN on site notified

Other Meds:

Current Illness:

ID: 1064666
Sex: F
Age: 55
State: IL

Vax Date: 02/27/2021
Onset Date: 03/01/2021
Rec V Date: 03/02/2021
Hospital:

Lab Data:

Allergies: Sulfa drugs, msg

Symptoms: Big red swollen area all around site of injection. Slightly itchy... painful. Also I have had the chills and fever like symptoms for the past 2 days. These symptoms seem to be abating and now my arm is swelling!!

Other Meds: Fish oil, vitamin D, megaspore probiotic, Orenda immune, mega quinine k27

Current Illness: None

ID: 1064667
Sex: F
Age: 61
State:

Vax Date: 02/27/2021
Onset Date: 02/27/2021
Rec V Date: 03/02/2021
Hospital:

Lab Data:

Allergies: None known

Symptoms: Chills and headache beginning 10 pm of the day of injection, followed by fever, nausea, body aches, sinus congestion soon thereafter and extreme fatigue. Aleve (2 tablets) at 7 am the next morning with little, if any, relief but perhaps prevented it from becoming worse and another at 2:30 am on Monday morning (the second day). Slept, although not always well, for the better part of 32 hours, with less than 3 hours of being awake and up, trying to eat little. Was able to make it through a nine hour shift on Monday, still with no appetite and a bit off (attributed to not being truly rested despite 32 hours in bed).

Other Meds: Simvastatin, B12, Calcium, Vit D, Iron

Current Illness: None

ID: 1064668
Sex: F
Age: 21
State:

Vax Date: 03/01/2021
Onset Date: 03/01/2021
Rec V Date: 03/02/2021
Hospital:

Lab Data: None

Allergies: NKDA

Symptoms: 2 syncopal episodes 10-12 hours after receipt of vaccine.

Other Meds: None

Current Illness: None

ID: 1064669
Sex: F
Age: 30
State: OR

Vax Date: 01/15/2021
Onset Date: 01/20/2021
Rec V Date: 03/02/2021
Hospital:

Lab Data: Ultrasound on 1/21/2021- see above. Confirmed 3 swollen lymphnodes.

Allergies: None known

Symptoms: I received first Moderna dose on 1/15/2021 and then 5 days later (1/20/2021) I woke up with an incredibly sore and swollen lump near my collarbone. I went in to see my primary care doctor on the same day. She referred me to get an ultrasound done (1/21/2021) which confirmed it was 3 swollen supraclavicular lymphnodes, ranging up to roughly 2 cm. The swelling and pain went away in a week however the swollen lymphnodes did not. I got my second injection on 2/11/2021, which did not trigger any changes in the size or swelling of the lymphnodes. It has now been almost 3 weeks since my second dose and the size of the swollen lymphnodes remains unchanged. I have had one follow-up visit with my doctor who advised we check in in 2 weeks if the lymphnodes remain changed.

Other Meds: Seasonal birth control

Current Illness: N/A

ID: 1064670
Sex: F
Age: 62
State: LA

Vax Date: 02/23/2021
Onset Date: 02/28/2021
Rec V Date: 03/02/2021
Hospital:

Lab Data: CT Scan and blood work at ER on March 1, 2021

Allergies: None

Symptoms: Bell?s Palsy

Other Meds: Liothyronine, levothyroxine, progesterone, estriol, rosuvastatin

Current Illness: None

ID: 1064671
Sex: F
Age: 58
State: MS

Vax Date: 02/25/2021
Onset Date: 02/25/2021
Rec V Date: 03/02/2021
Hospital:

Lab Data:

Allergies: penicillin

Symptoms: Distinct lump at injection site (initially 2 inches around, one-half inch deep at center, when first noticed, 12 hours after injection). Injection was given by pinching my arm at injection site (thick pinch). My arms are both muscular and fat. At present, 5 days later, the lump is beginning to soften and reduce in size. Within the first 24 to 48 hours after injection, my arm was both sore and itchy, but that is starting to diminish at present.

Other Meds: metformin, telmisartan

Current Illness: none

ID: 1064673
Sex: F
Age: 79
State: NY

Vax Date: 02/25/2021
Onset Date: 03/02/2021
Rec V Date: 03/02/2021
Hospital:

Lab Data:

Allergies: Neomycin Sulfates, Latex, Cefalaxin

Symptoms: Large red rash around injection site

Other Meds: Rosuvastatin 20 mg, Metformin Er 500 mg, , Atenolol 25 mg, Levothyroxine 5 mg, Coq10 300 mg, Vitamin D3 125 mg, Zinc 50 mg, Vitamin B1 100 mg, Vitamin B6 100 mg

Current Illness:

ID: 1064674
Sex: F
Age: 40
State: TX

Vax Date: 02/09/2021
Onset Date: 02/09/2021
Rec V Date: 03/02/2021
Hospital:

Lab Data: No medical tests done to date. ED was called on 03/03/2021 - elevated blood pressure and elevated beast beat. Will be getting blood work done this week (03/03/2021).

Allergies: Medications - Sulfa drugs; Bactrim; Clindamycin; Augmentin. Food allergies - wine from hot dogs.

Symptoms: Immediately after given vaccine - feeling of lump in throat. Unable to swallow, shortness of breath, rapid heart beat, flush feeling, intense shaking (especially in legs), pain in chest, lightheadedness, dizziness (ruled anxiety) and was monitored for 40 minutes. Was given orange juice and water and allowed to remove mask to catch breath. Almost everyday since this event, the same event keeps repeating it self (almost daily for 3 weeks). I am unable to control these episodes. Emergency department (ED) has been called and I have gone to see my nurse practitioner. Been trying to make an appointment with my doctor for this week. I have lost 5 pounds (down to 105 lbs. so I can't afford to loose more weight) since this first happened and I have also lost my appetite and unable to function normally.

Other Meds: M?nelas 24 Fe oral birth control

Current Illness: N/A

ID: 1064675
Sex: M
Age: 43
State: CA

Vax Date: 02/03/2021
Onset Date: 02/06/2021
Rec V Date: 03/02/2021
Hospital:

Lab Data:

Allergies: None

Symptoms: Left shoulder pain since 2/6/21 Scapular winging since 2/11/21 Left shoulder weakness 2/11/21 Muscle fasiculations since 2/28/21

Other Meds: None

Current Illness: None

ID: 1064676
Sex: F
Age: 63
State: WA

Vax Date: 02/24/2021
Onset Date: 03/01/2021
Rec V Date: 03/02/2021
Hospital:

Lab Data: Happening 3/2.

Allergies: Penicillin; Morphine; Sulfa

Symptoms: All three reactions were the same. I woke up feeling like my throat had a flap that was not allowing me to inhale. I had been snoring and work up abruptly because I couldn't breathe at that moment. If I inhaled sharply or sniffed hard to try and clear my throat, my airway blocked. I had a fever and also swollen glands in my neck and under my jaw. Once I got out of bed, I drank a glass of cold water and walked outside in the cold. I felt like it was an allergic reaction; so I took a Benadryl and I tried to go back to bed, but when I laid down it seemed worse, so I spent the night in my recliner. The first reaction was the worst in severity and happened about two weeks after my first injection. The second reaction was less than two weeks later, the last one happened 4 days after my second injection. All three incidents lasted about 12 hours, but I still feel like my glands are a bit swollen, and I have a hesitation when I swallow. I talked to my doctor today 3/1, he ordered a COVID test and ordered me to quarantine until I get the results.

Other Meds: Synthroid; Adderall

Current Illness: None prior at all; however this adverse reaction form only offers one date. The date I entered is for the date of my first injection 1/27, I have had three episodes of an adverse reaction, the last one was after my second injection on 2/24/2021. The reaction happened 3/1/2021.

ID: 1064678
Sex: F
Age: 51
State: VA

Vax Date: 01/08/2021
Onset Date: 02/05/2021
Rec V Date: 03/02/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Fever chills fatigue and ongoing hot flashes and cold spells where I cannot get warm. Temperature swings are terrible for over 3 weeks since the second vaccine

Other Meds:

Current Illness:

ID: 1064679
Sex: F
Age: 78
State: CA

Vax Date: 02/17/2021
Onset Date: 02/26/2021
Rec V Date: 03/02/2021
Hospital:

Lab Data: None

Allergies: Slight allergy to pollens - grass and tree

Symptoms: I have a rather large welt on my right arm surrounding the vaccination site - about 3 inches by 8 inches or so. It looks like a hive. I only noticed it when it began to itch. The site is a bit sore and still itches four days after onset. I have been taking Tylenol for it which seems to help. Is this really a "rare" reaction so long after receiving the vaccination? Just curious.

Other Meds: LEVOTHYROXINE and CHLORTHALIDONE

Current Illness: None

ID: 1064680
Sex: F
Age: 61
State: CA

Vax Date: 02/03/2021
Onset Date: 02/04/2021
Rec V Date: 03/02/2021
Hospital:

Lab Data: Urgent Care visits at Day 3, Day 5 and Day 9. ER visit on Day 5. Treated with 2 antibiotics and Minor surgery to open abscess and alleviate accumulation of pus. Additional treatment required to relieve ongoing swelling after Day 9.

Allergies: Penicillin

Symptoms: Severe paronychia (infection under the fingernail) that developed within 24 hours of administration of the first dose of Moderna. No previous history of skin/ nail infections. Nail turned green, finger swollen and extremely painful spreading downward toward the knuckle within 2 days. Required 3 trips to Urgent Care and one trip to the ER. Antibiotic resistant infection that began to spread up the arm. Second antibiotic required 2 week course to resolve infection. Pain and sensitivity continue after one month.

Other Meds: Fluoxetine

Current Illness: Asthma

ID: 1064681
Sex: F
Age: 48
State: AZ

Vax Date: 03/01/2021
Onset Date: 03/01/2021
Rec V Date: 03/02/2021
Hospital:

Lab Data:

Allergies: no

Symptoms: Sore arm, Very fatigue and chills

Other Meds: Motrin

Current Illness: no

ID: 1064682
Sex: F
Age: 53
State: MN

Vax Date: 02/16/2021
Onset Date: 02/17/2021
Rec V Date: 03/02/2021
Hospital:

Lab Data: Went to the doctor and chiropractor

Allergies: None

Symptoms: Significant ringing in the ears

Other Meds: Vitamins, Flonase

Current Illness: None

ID: 1064683
Sex: F
Age: 39
State: CA

Vax Date: 02/27/2021
Onset Date: 02/27/2021
Rec V Date: 03/02/2021
Hospital:

Lab Data:

Allergies: None known

Symptoms: Moderna COVID-19 Vaccine EUA Approximately 5 hours after second dose of Moderna vaccine began to feel tired with nausea and a headache. Approximately 8 to 9 hours after receiving vaccine also experienced chills, muscle aches, soreness at injection site, body aches, and a fever of ~101.7 degrees F. The Fever continued for approximately 24 hours, as well as all other symptoms. Approximately 40 hour after receiving vaccine developed a metallic taste in mouth when eating or drinking food. Nausea, headache, lethargic feeling continued ~40 hours after vaccine as well.

Other Meds: Synthroid, multi-vitamin, vitamin D

Current Illness:

ID: 1064684
Sex: F
Age: 88
State: OR

Vax Date: 02/11/2021
Onset Date: 02/19/2021
Rec V Date: 03/02/2021
Hospital:

Lab Data: VL Lower Venous Duplex-Left performed on 2/19/2021 REASON FOR EXAM: R22.42 LOCALIZED SWELLING, MASS AND LUMP, LEFT LOWER LIMB COMPARISON: None available. TECHNIQUE: Grayscale, color Doppler and spectral Doppler imaging of the left lower extremity venous system was performed. FINDINGS: Distal left common femoral vein, saphenous confluence, and superficial femoral vein all appear patent with normal compressibility, color flow and Doppler augmentation. There is an acute appearing occlusive thrombus within the popliteal vein extending distally into the posterior tibial vein. Visualized portion of the peroneal vein appears patent. Greater saphenous vein is patent. IMPRESSION: Occlusive thrombus within the popliteal vein extending into the posterior tibial vein.

Allergies: NKDA

Symptoms: Deep vein thrombosis (DVT) of left lower extremity She reported swelling of her left leg and was seen at Family Medicine Urgent Care on 2/19/2021 and was diagnoses with a thrombosis of the left popliteal vein. She was treated with Xarelto for anticoagulation and compression stockings. Her treatment course was uncomplicated when I saw the patient at follow up and was made aware of her condition at her appointment with me on 3/1/2021.

Other Meds: Acetaminophen, diclofenac gel, metoprolol, Miralax, pramipexole, tramadol

Current Illness: Sedentary lifestyle

ID: 1064685
Sex: F
Age: 22
State: NM

Vax Date: 02/26/2021
Onset Date: 02/26/2021
Rec V Date: 03/02/2021
Hospital:

Lab Data: None

Allergies: None

Symptoms: Very sore left arm, all over body ache (including feet, legs, hands & fingers, jaw, etc.), dizziness, naseau, and fever

Other Meds: Omega 3 Fish Oil Bupropion Venlafaxine

Current Illness: None

ID: 1064686
Sex: F
Age: 52
State: VT

Vax Date: 03/01/2021
Onset Date: 03/02/2021
Rec V Date: 03/02/2021
Hospital:

Lab Data:

Allergies: None

Symptoms: Fever, body aches, headache, chills, nausea, cough

Other Meds: None

Current Illness: None

ID: 1064687
Sex: F
Age: 68
State: ID

Vax Date: 02/10/2021
Onset Date: 02/12/2021
Rec V Date: 03/02/2021
Hospital:

Lab Data:

Allergies: Gluten; alcohol; Zyprexa; contrast IV iodine; Geodon; Lamictal; Aspirin; Ibuprofen

Symptoms: I take a biologic called Simponi ARIA for control of my rheumatoid arthritis. I had just taken the infusion about 13 or 14 days prior to the COVID19 shot. Of course it lowers my immune system so that I don't get attacked by RA. About 2 days after getting the COVID19 shot I noticed that my RA symptoms were starting to return. Each day that went by they started to get worse and worse. It has been about three weeks now and I feel as bad as I did before I started the infusions. Horrible in fact. I feel as if the COVID19 really ramped up my immune system not only against the coronavirus; but it so got it going that it is not responding to the infusion that is in my bloodstream. The arthritis doctor didn't seem to agree; but from what I've seen in writing, and it's taking me days of searching. I think that's what it is. Now I really worry about getting the second shot. My doctor to start me on a three-day system of Prednisone to help stop the reaction of my immune system and he is going to put me back on methotrexate to also help.

Other Meds: Adderall; Losartan; Simponi ARIA; Estradiol; Levothyroxine; Pantoprazole; hydroxyzine; Montelukast; Symbicort

Current Illness: None

ID: 1064688
Sex: F
Age: 40
State: ID

Vax Date: 02/17/2021
Onset Date: 02/17/2021
Rec V Date: 03/02/2021
Hospital:

Lab Data: Mri. Bloodwork.

Allergies:

Symptoms: Severe headache, from back of head to front forehead. Lasting two weeks exactly. Two grand-mal seizures on day 13. Unknown if seizures were related.

Other Meds:

Current Illness:

ID: 1064689
Sex: F
Age: 56
State: AK

Vax Date: 02/20/2021
Onset Date: 02/21/2021
Rec V Date: 03/02/2021
Hospital:

Lab Data: none, just advised my doctor.

Allergies: No food or medication, latex mild

Symptoms: Modern 2nd shot of two, given exactly when due. I have neck/spine injury. Felt like this injury did on day 1, really painful, like someone hit me in the head. Fever day night 2, headache, body aches, glands swelled all over my body, not just near left arm. Went away day 5 and felt just like usually did. Felt like my body abandoned repairing and fighting old injuries and concentrated on this vaccine.

Other Meds: Blood pressure medication

Current Illness: I have a neck injury from 2006 that is ongoing and gives me issues. Neck surgery in September 2018. Hashimotos.

ID: 1064691
Sex: F
Age: 36
State: VA

Vax Date: 02/26/2021
Onset Date: 03/01/2021
Rec V Date: 03/02/2021
Hospital:

Lab Data: TSH, Free T4, CBC, CMP, EKG

Allergies: NKA

Symptoms: Patient with fever 100.7F and fatigue on 2/27/21. Okay next day, then in afternoon of 3/1/21 patient with tingling in face and body for approximately 30 minutes and some facial drooping on right side for approximately 5 minutes. Patient able to talk, no arm drift, 7th CN intact.

Other Meds: Vyvanse, Malarone (of note, Vyvanse was started on same day as vaccination)

Current Illness: None

ID: 1064692
Sex: F
Age: 41
State: NC

Vax Date: 02/24/2021
Onset Date: 02/25/2021
Rec V Date: 03/02/2021
Hospital:

Lab Data: None at this time

Allergies: None

Symptoms: Soreness, bruising and rash on forehead

Other Meds: Omeprazole, fish oil, multivitamin

Current Illness: None

ID: 1065071
Sex: F
Age: 18
State: OH

Vax Date: 07/08/2020
Onset Date:
Rec V Date: 03/02/2021
Hospital:

Lab Data:

Allergies:

Symptoms: extra dose administered; no adverse events; This spontaneous report was received from a Nurse Practitioner and refers to a 18 year old female patient. The patient's concurrent conditions, concomitant medications, past medical history and drug reactions/allergies were not provided. On 08-JUL-2020, the patient was vaccinated with a fourth dose (extra dose administered) of hpv rl1 6 11 16 18 31 33 45 52 58 vlp vaccine (yeast)(GARDASIL 9) lot # S004578 and expiration date reported as 29-SEP-2021, given in the in the right deltoid (previous vaccination schedule and route of administration was not mentioned) for prophylaxis. At the reporting time no adverse events or symptoms were reported. There was no product quality complaint involved. The reporter considered extra dose administered as medically significant event. combinationproductreport: Yes; brandname: GARDASIL 9 SYRINGE (DEVICE); commondevicename: HPV rL1 6 11 16 18 31 33 45 52 58 VLP vaccine (yeast); productcode: FMF; devicetype: SYRINGE, PISTON (FMF); manufacturername: Merck Sharp & Dohme Corp; devicelotnumber: S004578; expirationdate: 29-SEP-2021; deviceage and unit: 0 ; operatorofdevice: Health Care Professional; malfunction: Unknown; deviceusage: Initial; evaluatedbymfr: Not returned to manufacturer; reasonfornoneval: 81 Other; labeledsingleusedevice: No; mdcpreportability: No; mdcpreprationale: Case information does not meet the criteria for Reportability

Other Meds: GARDASIL 9 SYRINGE (DEVICE)

Current Illness:

ID: 1065072
Sex: F
Age: 75
State: WA

Vax Date: 01/08/2020
Onset Date: 01/09/2020
Rec V Date: 03/02/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Breaking out; Fever Blisters on her face; Face is very hot; Tingling; Shivering; This case was reported by a consumer via call center representative and described the occurrence of tingling in a 74-year-old female patient who received Herpes zoster (Shingrix) for prophylaxis. On 8th January 2020, the patient received the 2nd dose of Shingrix (intramuscular). On 9th January 2020, 1 days after receiving Shingrix, the patient experienced tingling and shivering. On 11th January 2020, the patient experienced skin breakout, fever blister and feeling of warmth facial. On an unknown date, the outcome of the tingling, shivering, skin breakout, fever blister and feeling of warmth facial were unknown. It was unknown if the reporter considered the tingling, shivering, skin breakout, fever blister and feeling of warmth facial to be related to Shingrix. Additional details were provided as follows: It was reported that one day after receiving the Shingrix patient had tingling and shivering and 3 days after the vaccination patient started breaking out with Fever Blisters on her face and her face was very hot. The reporter did not consent to follow up.

Other Meds:

Current Illness:

ID: 1065073
Sex: F
Age:
State: IL

Vax Date: 02/10/2021
Onset Date: 02/10/2021
Rec V Date: 03/02/2021
Hospital: Y

Lab Data:

Allergies:

Symptoms: Lymph glands were swollen; Headache; A spontaneous report was received from a healthcare professional regarding his coworker, female nurse ,who received Moderna Covid-19 vaccine and have experienced headache and swollen lymph glands. The patient's medical history was not provided. Her concomitants were not provided. No information on allergies. On 10-FEB-2021, prior to the onset of events, the patient received her first of two planned doses of Covid-19 vaccine for the prophylaxis of Covid-19 infection. On the same day, she felt headache and her lymph glands were swollen. She stayed overnight at the hospital for treatment. Action taken with 2nd dose of Moderna Covid-19 vaccine was not reported. The outcome of the events were unknown at the time of report.; Reporter's Comments: Based on the current available information and temporal association between the use of the product and the onset date of the reported events, a causal relationship cannot be excluded.

Other Meds:

Current Illness:

ID: 1065074
Sex: F
Age:
State:

Vax Date: 01/19/2021
Onset Date:
Rec V Date: 03/02/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Bell's Palsy; A spontaneous report was received from a consumer concerning a female patient who received Moderna's COVID-19 vaccine (mRNA-1273) and developed Bell's palsy. The patient's medical history was not provided. Concomitant product use was not provided. On 19 Jan 2021, the patient received their first of two planned doses of mRNA-1273 (Lot number: not provided) intramuscularly for prophylaxis of COVID-19 infection. On an unknown date, post vaccination, the reporter who is the patient's son, stated the patient was diagnosed with Bell's palsy. Treatment for the event included, hydroxypropyl methylcellulose, prednisone and valacyclovir. Action taken with mRNA-1273 in response to the events was unknown. The outcome of the event, Bell's palsy, was considered unknown.; Reporter's Comments: Very limited information regarding the event of Bell's Palsy has been provided at this time. Further information has been requested.

Other Meds:

Current Illness:

ID: 1065075
Sex: F
Age:
State:

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

Lab Data:

Allergies:

Symptoms: Hospitalized; Unable to receive second dose of vaccine; Case reference number MOD-2021-014001 is a spontaneous case report sent by a Non-Health Professional on 15-FEB-2021 00:00:00 . On the patient started taking Moderna COVID-19 Vaccine for COVID-19 vaccination. After vaccination she was hospitalized and she was unable to receive the second dose of the vaccine. Action taken with mRNA-1273 was not provided. Terse Narrative (for PSUR narratives and signal review) Brief 3 line summary of above for CIOMS listing: Report Source- Non-Health Professional, Age- , Sex- Female, Suspect Drug- Moderna COVID-19 Vaccine, Treatment- Diagnosis\Outcome- hospitalized - unknown; unable to receive the second dose of the vaccine - resolved.; Reporter's Comments: This case concerns a female of unknown age who experienced a serious unexpected event of Hospitalisation and nonserious unexpected event of Inappropriate schedule of product administration, in that she "unable to receive the second dose of the vaccine". The events occurred with unknown latency after the first dose of mRNA-1273. Very limited information regarding these events has been provided at this time. Further information has been requested.

Other Meds:

Current Illness:

ID: 1065076
Sex: M
Age: 71
State: FL

Vax Date: 01/15/2021
Onset Date: 02/12/2021
Rec V Date: 03/02/2021
Hospital: Y

Lab Data:

Allergies:

Symptoms: Emergency pacemaker; Pain in left shoulder; missed second dose; A spontaneous report was received from a consumer regarding her husband, a 71 year old male, who received first dose of Moderna Covid-19 vaccine and experienced missed the second dose due to hospitalization, emergency pacemaker insertion and pain in shoulder . The patient's medical history includes high blood pressure, hereditary heart disease, Fuchs Dystrophy and heart attack last year. His concomitant medications were amlodipine 5 mg tablets daily, potassium chloride and indapamide. No information on allergies. On 15-JAN-2021, prior to the onset of events, the patient received his first of two planned doses of Covid-19 vaccine intramuscularly on his left arm for the prophylaxis of Covid-19 infection(Lot#012LZ0A or 017LZ0A) She is not sure about the Lot number as she couldn't read the handwriting. On 11-FEB-2021, Patient had Emergency pacemaker insertion done at the hospital, where he stayed for two more days and discharged on 14-FEB-2021. As per his wife, this event is related to his previous heart problems which are ongoing for a long time. His 2nd dose of vaccine is scheduled on 12-FEB-2021, which he missed due to his hospitalization. Doctor said "forget about the shot" after seeing his results in monitor. She thinks, his doctor wouldn't talk about the 2nd dose of vaccine now, so wants to wait till his follow up appointment in March and he may get his second dose in 5-6-week limit. After being discharged from the hospital, wife reports husband is "starting to feel better." Sleeps a few hours and gets up and goes lays back down. Still experiencing pain in shoulder. Action taken with 2nd dose of Moderna Covid-19 vaccine was postponing of appointment until he is fine. The outcome of the event emergency pacemaker insertion was recovered and pain in shoulder is not recovered.; Reporter's Comments: This report refers to a case of inappropriate schedule of product administration for mRNA-1273. Based on the current available information and the mechanism of action of mRNA-1273 vaccine, the events of cardiac pacemaker insertion and arthralgia are assessed as unlikely related. The patient's medical history of high blood pressure, hereditary heart disease and heart attack are risk factors for cardiac pacemaker insertion and confounds causality.

Other Meds: AMLODIPINE; POTASSIUM CHLORIDE; INDAPAMIDE

Current Illness: Heart disease, unspecified; Hypertension

ID: 1065077
Sex: M
Age:
State: IN

Vax Date: 01/28/2021
Onset Date: 01/28/2021
Rec V Date: 03/02/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Can't taste or smell food; Can't taste or smell food; No desire to eat; Headache; Severe bleeding; No power; He got tested and the blood became too thick; A spontaneous report was received from a consumer concerning a male patient of unknown age who received Moderna's COVID-19 vaccine (mRNA-1273) and experienced severe bleeding, he got tested and the blood became too thick, headache, no power, no desire to eat, and can't taste or smell food. The patient's medical history was not provided. Concomitant product use was provided as anti-depressants and anti-anxiety medication but was unspecified. On 28JAN2021 prior to the onset of the symptoms, the patient received their first of two planned doses of mRNA-1273 (Batch number:030L20A) intramuscularly for prophylaxis of COVID-19 infection. Patient received the 1st shot of the mRNA-1373 vaccine on 28Jan2021. Patient reported hearing that the vaccine could have messed with his coumadin levels. Patient got tested and reported that the blood became too thick and that after treatment to thin the blood, he had severe bleeding. Patient has a rhino rocket in his nose. About two weeks later after the vaccine, patient reported a headache, having no power, couldn't taste or smell food and had no desire to eat. Patient also reported following up with his Primary Care around about taking more anxiety medication due to this situation. The patient's doctor has provided his approval. Patient wanted to know if the side effects he is experiencing two weeks after the vaccine are normal. Treatment information was not provided. The outcome of the events was unknown.; Reporter's Comments: There is not enough detail in the absence of patient's medical history, onset date and list of concomitant medications to assess the events of blood became too thick and severe bleeding and can't taste or smell food. The events of headache, no power, no desire to eat are temporarily associated with the vaccine administration and a causal association cannot be excluded.

Other Meds:

Current Illness:

Date Died:

ID: 1065078
Sex: M
Age:
State:

Vax Date: 12/22/2020
Onset Date: 01/11/2021
Rec V Date: 03/02/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Unresponsive; A spontaneous report was received from a Reporter concerning a 25 Years-old male patient who received Moderna's COVID-19 vaccine (mRNA-1273). The patient's medical history was not provided. No relevant concomitant medications were reported. On 22-DEC-2021, prior to the onset of the events, the patient received their first of two planned doses of mRNA-1273 (lot/batch: unknown) for prophylaxis of COVID-19 infection. On 01-JAN-2021, The patient became unresponsive and died which is serious. No treatment information was provided. Action taken with mRNA-1273 in response to the events was not reported. On 01-JAN-2021, the outcome of the event unresponsive became fatal. patient died.; Reporter's Comments: Very limited information regarding this event has been provided at this time. Further information has been requested.; Reported Cause(s) of Death: unknown cause of death

Other Meds:

Current Illness:

ID: 1065079
Sex: F
Age: 71
State: CA

Vax Date: 01/29/2021
Onset Date: 01/29/2021
Rec V Date: 03/02/2021
Hospital: Y

Lab Data: Test Date: 20210202; Test Name: blood pressure; Result Unstructured Data: 60/24

Allergies:

Symptoms: kindeys started to fail; blood pressure 60/24; red spots around the injection site; nausea; vomiting; diarrhea; cellulitis at the injection site; A spontaneous report was received from a nurse who was also a 61-year-old female patient who received Moderna's COVID-19 vaccine (mRNA-1273) and experienced red spots around the injection site, nausea, vomiting, diarrhea, kidneys started to fail, and blood pressure 60/24. Medical history included type 2 diabetes mellitus, lung disease, and high blood pressure. Concomitant medication included unspecified cholesterol medicines, unspecified heart medicines, levopridsone, and unspecified type 2 diabetes mellitus medicines. On 29 Jan 2021, the patient received their first of two planned doses of mRNA-1273 (lot number 057G20A) intramuscularly n the left deltoid for prophylaxis of COVID-19 infection. On 29 Jan 2021, the patient experienced cellulitis at the injection site. On 02 Feb 2021, the patient experienced red spots around the injection site, nausea, vomiting, diarrhea, kidneys started to fail, and blood pressure 60/24 (no units or reference range provided). The patient was hospitalized from 04 Feb 2021 to 07 Feb 2021. Treatment for the events included hydration, unspecified antibiotics, and levid for blood pressure. Action taken with the mRNA-1273 was not reported. The outcome of the events of cellulitis at the injection site, red spots around the injection site, nausea, vomiting, diarrhea, kidneys started to fail, and blood pressure 60/24 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: Blood pressure high; Lung disease; Type 2 diabetes mellitus

ID: 1065080
Sex: F
Age: 47
State: NJ

Vax Date: 02/07/2021
Onset Date: 02/11/2021
Rec V Date: 03/02/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Erythema multiforme; Swelling on the face; Full body rash; Joint pain; A spontaneous report was received from a HCP concerning a 47 Years-old female patient who received Moderna's COVID-19 vaccine (mRNA-1273) and experienced events - Swelling on the face, Joint pain, Full body rash, and Erythema multiforme (medically significant event). The patient's medical history was not provided. No relevant concomitant medications were reported. On 07-Feb-2021, prior to the onset of the events, the patient received the second of two planned doses of mRNA-1273 (lot/batch: 013L20A) intramuscularly for prophylaxis of COVID-19 infection. Four days after receiving the vaccine the oatient started experiencing swelling on the face, joint pain, full body rash and erythema multiforme. Laboratory details were not provided. Action taken with mRNA-1273 in response to the events was not reported. At the time of this report, the outcome of the events, swelling on the face, Joint pain, Full body rash, and Erythema multiforme were unknown.; Reporter's Comments: Based on the information provide which includes a strong temporal association and excluding other etiologies, a causal association between the reported events and the administration of the mRNA-1273 cannot be excluded. Joint pain, rash and facial swelling are consistent with the known safety profile of the product.

Other Meds:

Current Illness:

ID: 1065081
Sex: F
Age:
State: FL

Vax Date: 01/07/2021
Onset Date: 01/14/2021
Rec V Date: 03/02/2021
Hospital:

Lab Data:

Allergies:

Symptoms: covid pneumonia; diarrhea, stomach issues; weakness; no appetite; Covid; A spontaneous report was received from a consumer concerning an 88-year-old, female patient who experienced diarrhea, got sick with COVID, stomach issues, weakness, no appetite, and covid pneumonia. The patient's medical history was not provided. Products known to have been used by the patient, within two weeks prior to the event, included Eliquis, Omeprazole, and Metoprolol. On 07JAN2021, approximately 7days prior to the onset of the symptoms, the patient received their first of two planned doses of mRNA-1273 (Batch number not provided) intramuscularly for prophylaxis of COVID-19 infection. Caller stated that her mother in law who is 88 years old received the Moderna vaccine on 07Jan2021 and within 7 days, she got sick. Patient had had diarrhea, stomach issues, weakness, no appetite and ended up with covid pneumonia. Treatment for the events included Regeneron antibody therapy. Caller would like to know if the therapy negated the benefits of the vaccine. Action taken with mRNA-1273 in response to the event was not provided/unknown. The events, diarrhea, got sick with COVID, stomach issues, weakness, no appetite, and covid pneumonia were considered recovered/resolved.; Reporter's Comments: This case concerns an 88-year-old female who experienced a serious unexpected event of COVID-19 pneumonia along with unexpected COVID-19, decreased appetite, and asthenia. The events occurred 8 days after first dose of mRNA-1273. Treatment included Regeneron antibody. Further information has been requested. Based on 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.

Other Meds: APIXABAN; OMEPRAZOLE; METOPROLOL

Current Illness:

ID: 1065082
Sex: M
Age: 56
State: NM

Vax Date: 01/28/2021
Onset Date: 01/28/2021
Rec V Date: 03/02/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Anaphylactic reaction; A spontaneous report was received from a physician concerning a 56-year-old, male patient, who received their first of two planned doses of mRNA-1273, and who developed anaphylactic reaction. The patient's medical history included blindness and severe allergies to shellfish. Products known to have been used by the patient, within two weeks prior to the event, included Losartan and Melatonin. On 28 JAN 2021, approximately 15 minutes prior to the onset of the symptoms, the patient received their first of two planned doses of mRNA-1273 (Batch number: 032L20A) intramuscularly in the left arm for prophylaxis of COVID-19 infection. Patient's wife called to indicate that her husband had an anaphylactic reaction to the mRNA-1273 vaccine. Patient received the vaccine on 28 JAN 2021 in his left arm. Patient's wife indicated that her husband texted her at 3.21 pm to let her know that he has gotten the shot, indicating that he must have received it around 3.19 pm. Patient's wife indicated that around 3.34 pm, patient said he'd had an anaphylactic reaction, that he had administered a shot of epinephrine and that an ambulance was on its way. The patient's wife noted that the reaction happened within 15 minutes or so. Once in the hospital, the patient was administered Pepcid and Steroid orally. Additional treatment medication for the event included the previously epinephrine and a shot of Benadryl. Action taken with mRNA-1273 in response to the event(s) was not provided/unknown. The outcome of the event was unknown.; Reporter's Comments: Based on the current available information and temporal association between the use of the product and the onset date of the event, a causal relationship cannot be excluded. Patient's significant medical history included severe allergies to shellfish.

Other Meds: LOSARTAN; MELATONIN

Current Illness: Blind; Shellfish allergy (Severe Allergy to shellfish)

ID: 1065083
Sex: F
Age: 55
State: CO

Vax Date: 01/12/2021
Onset Date: 02/11/2021
Rec V Date: 03/02/2021
Hospital:

Lab Data:

Allergies:

Symptoms: terrible time finishing sentences/such a hard time communicating; brain fog; Dizziness/remained dizzy for several hours/the room was spinning; shaking literally; congestion; Cough; my major joints (hip, knee, wrist, elbow, shoulder) were on fire; She felt she was going to die; vomited 2-3 hours; head felt on fire, when laying on her left side she could feel on the top of her head the pain move to the left side,type of pain in patient's head far more severe than any migraine patient's ever had; when lying down patient's head felt on fi; fatigued so badly; 103 fever for 2 days; swelling of the tongue; couldn't walk/could only crawl; when moving to the right side, she felt liquid in her brain pouring to that side,like an epilepsy attack in a smaller scale; unbelievable pain; debilitated; pain behind her eye so sharp as if her eye would come out; her body was cramped; A spontaneous report was received from a consumer who was also a 55 years old, female patient who received Moderna's COVID-19 Vaccine (mRNA-1273) and who experienced swelling of the tongue/ Swollen tongue; dizziness/ Dizziness; 103 fever for 2 days/ Pyrexia; shaking literally/ Tremor; like an epilepsy attack in a smaller scale/ Feeling abnormal; fatigued so badly/ Fatigue; patient's body was cramped/ Muscle spasms; couldn't walk/ Gait inability; debilitated/ Asthenia; could only crawl/ Gait inability; vomited two to three hours/ Vomiting; pain behind patient's eye so sharp as if patient's eye would come out/ Eye pain; unbelievable pain/ Pain; type of pain in patient's head far more severe than any migraine patient's ever had; when lying down patient's head felt on fire, when laying on patient's left side patient could feel on the top of patient's head the pain move to the left side/ Headache; when moving to the right side, patient felt liquid in patient's brain pouring to that side/ Feeling abnormal; remained dizzy for several hours, the room was spinning/ Dizziness; my major joints (hip, knee, wrist, elbow, shoulder) were on fire/ Arthralgia; congestion/ Nasal congestion; cough/ Cough; patient felt patient was going to die/ Vaccination complication; brain fog/ Feeling abnormal; terrible time finishing sentences; like brain damage and such a hard time communicating/ Speech disorder. The patient's medical history included migraine which occurred several times a year. No relevant concomitant medications were reported. The patient received their first of two planned doses of mRNA-1273 (Batch number: 027L20A)) on 12-Jan-2021. On 11-Feb-2021, approximately ten minutes prior to the onset of the symptoms, the patient received their second of two planned doses of mRNA-1273 (Batch number: 030M20A) intramuscularly for prophylaxis of COVID-19 infection. On 11-Feb-2021, the patient experienced swelling of the tongue; dizziness; 103 fever for 2 days; shaking literally; like an epilepsy attack in a smaller scale; fatigued so badly; patient's body was cramped; couldn't walk; debilitated; could only crawl; vomited 2-3 hours; pain behind patient's eye so sharp as if patient's eye would come out; unbelievable pain, type of pain in patient's head far more severe than any migraine patient's ever had; when lying down patient's head felt on fire; when laying on patient's left side patient could feel on the top of patient's head the pain move to the left side; when moving to the right side, patient felt liquid in patient's brain pouring to that side; remained dizzy for several hours; the room was spinning; my major joints (hip, knee, wrist, elbow, shoulder) were on fire; congestion; cough and patient felt patient was going to die. On 15-Feb-2021, patient developed brain fog; terrible time finishing sentences; like brain damage and such a hard time communicating. Treatment for the event included one acetaminophen and twelve hours later patient had three ibuprofen. The patient received both scheduled doses of mRNA-1273 prior to the events; therefore, action taken with the drug in response to the events is not applicable. The outcome for the events the patient experienced swelling of the tongue; dizziness; one hundred and three fever for two days; shaking literally; like an epilepsy attack in a smaller scale; fatigued so badly; patient's body was cramped; couldn't walk; debilitated; could only crawl; vomited two to three hours; pain behind patient's eye so sharp as if patient's eye would come out; unbelievable pain, type of pain in patient's head far more severe than any migraine patient's ever had; when lying down patient's head felt on fire; when laying on patient's left side patient could feel on the top of patient's head the pain move to the left side; when moving to the right side, patient felt liquid in patient's brain pouring to that side; remained dizzy for several hours; the room was spinning; my major joints (hip, knee, wrist, elbow, shoulder) were on fire; congestion; cough and patient felt patient was going to die were recovered on 14-Feb-2021. The outcome of the events brain fog; terrible time finishing sentences; like brain damage and such a hard time communicating were not reported.; 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: 1065084
Sex: F
Age: 76
State: PA

Vax Date: 02/03/2021
Onset Date: 02/04/2021
Rec V Date: 03/02/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Diverticulitis; This spontaneous report was received from consumer on 18-FEB-2021, concerning a 76 year old female patient who was administered Moderna COVID-19 vaccine9( mRNA-1273). The patient experienced diverticulitis. The patient's medical history was not provided. Concomitant medications included was blood thinners. The patient received suspect product mRNA-1273 on 23 JAN 2021 prior to the onset event, the patient received their first dose of mRNA-1273 (lot number:030L20A) intramuscularly in an unknown arm for prophylaxis of COVID-19 infection. On 4 FEB 2021, approximately within 24 hours of receiving shot, the patient experienced diverticulitis. Treatment history was not reported. Action taken with the dose of mRNA-1273 in response to the event was unknown. The outcome of the event, diverticulitis was considered as unknown.; Reporter's Comments: This case concerns a 76-year-old female who experienced Serious unexpected event of Diverticulitis. The events occurred 2 days after the first dose of mRNA-1273. Treatment not reported. Event outcome unknown. Based on 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.

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 134,999

Page last modified: 14 December 2021 10:42pm