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: 1045137
Sex: F
Age: 80
State:

Vax Date: 02/20/2021
Onset Date: 02/21/2021
Rec V Date: 02/22/2021
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: Penicilin

Symptom List: Dysphagia, Epiglottitis

Symptoms: Rash on arm, red, pain on arm

Other Meds: Blood pressure Vitamins

Current Illness:

ID: 1045138
Sex: F
Age: 36
State: CA

Vax Date: 02/19/2021
Onset Date: 02/20/2021
Rec V Date: 02/22/2021
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: Erythromycin, sulfa drugs

Symptom List: Anxiety, Dyspnoea

Symptoms: 15 hours after injection I experienced severe joint pain all over my body. This continued until 32 hours post vaccine. Motrin and Tylenol helped but didn?t completely take all pain away. Injection arm was slightly sore. I was lethargic until 36 hours post vaccine. All symptoms subsided the next morning.

Other Meds: Flonase

Current Illness: None

ID: 1045139
Sex: F
Age: 34
State: AZ

Vax Date: 02/20/2021
Onset Date: 02/20/2021
Rec V Date: 02/22/2021
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: None

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

Symptoms: Low grade fever, headache, painful lump at injection site, redness at injection site, pain in arm that feels like its to the bone.

Other Meds: None

Current Illness: None

ID: 1045140
Sex: F
Age: 53
State: OR

Vax Date: 02/02/2021
Onset Date: 02/03/2021
Rec V Date: 02/22/2021
Hospital:

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

Lab Data:

Allergies: gluten (celiac disease)

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: About a day after the 1st vaccine, I got a rash on my face that felt like sandpaper. My face was became more swollen after four days and finally started decreasing in swelling after the 5th day. My eyelids were the most noticeable.

Other Meds: gabipentan

Current Illness:

ID: 1045141
Sex: F
Age: 43
State: IL

Vax Date: 02/12/2021
Onset Date: 02/13/2021
Rec V Date: 02/22/2021
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: Injection site erythema, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: Symptoms began approximately 12 hours after receiving shot- chills, body aches, loss of appetite. After sleeping from 12am until 11am the next morning, I awoke with fever and extreme exhaustion. I was unable to get out of bed or stay awake until 5pm, an hour after taking Tylenol. I also experienced. brain fog for several days after vaccination.

Other Meds: Probiotics

Current Illness:

ID: 1045144
Sex: M
Age: 32
State: CO

Vax Date: 02/05/2021
Onset Date: 02/05/2021
Rec V Date: 02/22/2021
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: None

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

Symptoms: I had sore arm, chills, fatigue and dizziness for 2 days. All other symptoms subsided but the dizziness has persisted.

Other Meds: Tylenol, Ibuprofen, meclizine, dimenhydrinate, Ativan

Current Illness: None

ID: 1045145
Sex: F
Age: 79
State: NJ

Vax Date: 02/16/2021
Onset Date: 02/16/2021
Rec V Date: 02/22/2021
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: Several antibiotics Summer fruit Pineapple

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Immediately nose started running, backdrip, hoarseness. After I left with my daughter, cough, mucous in chest, hoarseness, heaviness in chest, tickle in chest Have been on Benadryl and Nasacort since. Today is the 6 th day and I still need Benadryl every four hours Need a spray for chest. Have used albuterol. Tomorrow I will speak to the doctor

Other Meds: None

Current Illness: None

ID: 1045146
Sex: F
Age: 58
State: CA

Vax Date: 02/20/2021
Onset Date: 02/20/2021
Rec V Date: 02/22/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Pharyngeal swelling

Symptoms: None

Other Meds: Nine

Current Illness: None

ID: 1045147
Sex: F
Age: 72
State: FL

Vax Date: 02/18/2021
Onset Date: 02/19/2021
Rec V Date: 02/22/2021
Hospital:

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

Lab Data:

Allergies: No

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Swollen arm, muscle and joint aches, chills, elevated temp for 24-36 hours, temp between 100.6 and 101.8, diarrhea, exhaustion.. treated with Tylenol and water consumption

Other Meds: Multivitamin, Calcium, Fish Oil, Baby Aspirin, Glucosamine, B12

Current Illness: None

ID: 1045149
Sex: F
Age: 67
State: TX

Vax Date: 02/19/2021
Onset Date: 02/19/2021
Rec V Date: 02/22/2021
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: Septocaine with epinephrine Caused my throat to swell up and I had difficulty breathing.

Symptom List: Diarrhoea, Nasal congestion

Symptoms: I received the 2nd Covid injection. I went to the 15-minute waiting area. The waiting area was full, so my husband and I were standing. I stand and work every day, so this was not difficult. I texted my daughter, who is a hospital employee, and told her that we had a super experience with no wait and had already received our 2nd dose. However, 5 to 7 minutes after the injection, I SUDDENLY felt dizzy and weak and had to sit down. Within a minute or so, I could not stand or open my eyes. The weakness made it difficult to breath or talk. My husband had to lift me up into a wheelchair. I was taken to the ER. For the longest time, I could not even open my eyes or talk above a whisper. After 4 hours, I was able to get my eyes open and talk better. I, gradually, was able to move my hands and feet. Last of all, I could move my hips and walk. It was as if my body had been put to sleep. I could feel everything but my body wouldn?t move. As it wore off, my face and limbs felt slightly tingly. I was, basically, fine after 5 hours other than being tired from the experience. The doctors had no explanation for what happened and said it must be an emotional response to getting the shot. They wrote that I was not exerting enough effort to move my body. One said that I was hyperventilating when I pulled my mask up to breathe after he told me to hold my leg in the air. Though I tried, I was too weak to hold my leg up and it fell to the bed. The doctor told me that I should not tell anyone about what had happened or people would not come to get the Covid vaccination. He obviously knew that SOMETHING had happened that I couldn't control but he didn't put that in his report!

Other Meds: NP Thyroid Tablets 45Mg Prometrium Capsules 100 mg Estradiol Transdermal System, USP (Twice Weekly) .0375 mg/day Vitamin D3 3000IU

Current Illness: cough due to allergies

Date Died: 02/20/2021

ID: 1045150
Sex: M
Age: 59
State: SD

Vax Date: 02/10/2021
Onset Date: 02/20/2021
Rec V Date: 02/22/2021
Hospital:

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

Lab Data:

Allergies: NKDA

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

Symptoms: Patient found in home deceased.

Other Meds: Lisinopril Levetiracetam

Current Illness: Unknown

ID: 1045151
Sex: F
Age: 30
State: CA

Vax Date: 02/18/2021
Onset Date: 02/19/2021
Rec V Date: 02/22/2021
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: None known (also lifelong vegetarian, now vegan if that?s relevant)

Symptom List: Rash, Urticaria

Symptoms: Heartbeat racing five minutes after shot (but stopped before the 15 minute waiting period at clinic) Woke up next day around 9am and felt like I had a fever and chills, but checking temperature verified I did not. I also had a sore left arm, a headache, body aches, and some fatigue (general grogginess). I went to work that day and woke up the next day feeling fine again.

Other Meds: Daily vitamins (vitamin d, calcium, iron, b12, zinc)

Current Illness: None

ID: 1045152
Sex: F
Age: 61
State: CO

Vax Date: 02/19/2021
Onset Date: 02/20/2021
Rec V Date: 02/22/2021
Hospital:

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

Lab Data:

Allergies: PCN, Naproxen

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

Symptoms: Swollen red rash below injection site, red and warm to the touch

Other Meds: Valsarten 160mg Nortriptyline 25mg Vitamin D-3 5000 IU Bayer Asa 81mg Magnesium 400mg

Current Illness: 1/6 - root canal treated with amoxicillin 1/24 - urinary tract infection treated with Cipro

ID: 1045154
Sex: M
Age: 39
State: CA

Vax Date: 02/18/2021
Onset Date: 02/18/2021
Rec V Date: 02/22/2021
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: n/a

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

Symptoms: Pt reports "white coat syndrome" and "panic attacks" related to injections. Also reports feeling dizzy and appears anxious. 11:29 BP 167/102, P. 109 R. 21 Temp. 97.0 Spo2:96% 11:35 BP 164/101, P.96, Temp 97.5 Spo2:97% 11:50 BP 176/101 P.92 R. 20 Temp 97.6 Spo2:98% Pt laid on the floor with eyes closed and feet elevated. Instructed to used deep breathing techniques. Provided Benadryl 25mg PO as directed by MD standing orders. Patient was observed and left vaccination clinic after panic attack. Pt denied any symptoms and/or distress.

Other Meds: n/a

Current Illness: Patient reports history of "white coat syndrome" and "panic attacks"

ID: 1045155
Sex: F
Age: 65
State: WA

Vax Date: 02/15/2021
Onset Date: 02/15/2021
Rec V Date: 02/22/2021
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: pennicillin

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

Symptoms: headache, muscle/joint pain, fatigu?, temperature, nausea

Other Meds: none

Current Illness: none

ID: 1045156
Sex: F
Age: 40
State: TX

Vax Date: 02/11/2021
Onset Date: 02/19/2021
Rec V Date: 02/22/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: raised itchy hard quarter sized bump at vaccination site

Other Meds:

Current Illness:

ID: 1045157
Sex: F
Age: 35
State: CO

Vax Date: 02/19/2021
Onset Date: 02/20/2021
Rec V Date: 02/22/2021
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: Gluten sensitive, sulfa drug allergy

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

Symptoms: Large hot, red, painful bump.

Other Meds: Yaz birth control. Prilosec, flovent

Current Illness: No

ID: 1045158
Sex: F
Age: 61
State: TX

Vax Date: 02/09/2021
Onset Date: 02/10/2021
Rec V Date: 02/22/2021
Hospital:

Vax Type: HIBV
Manufacturer: MERCK & CO. INC.
Vax Name: HIB (PEDVAXHIB)
Lot:
Dose Series: UNK
Vax Route:
Vax Site: LG

Lab Data:

Allergies: Mobic, Gabapentin, Lyrica, Mold, Dust, Cedar, Hay

Symptom List: Ear pain, Hypoaesthesia

Symptoms: 2/10/21: Woke up with chills, no fever @5:15am, back to sleep, Temp 99.3F at 10:05am, Tylenol at 10:50am, Temp 100.3F at 5:15pm Temp 101.3F at 9:10pm and took tylenol and regular medications, Temp 100.6F at 10:55pm and went to sleep. 2/11/21: woke up with temp 98.7 at 10:00am, had body aches, red and feverish area where vaccine was given in upper left arm. The red, itchy and feverish area about 3 inches x 2 inches on upper left arm lasted about 5 days, also got a lump under left arm that lasted about 6 days and all of these went away by 2/17/21. But I've had more fatigue, and shortness of breath since this 2nd vaccine. Misses my doctor appointment on 2.17/21 due to the winter storm, not going anywhere , we were having all last week.

Other Meds: Tramadol 50mg,Cyclobenzaprine 5mg, Atorvastatin 40mg, Famotidine 20mg, Zytrec, Flonase Spray, Tylenol 650mg, Metformin 500mg, Gemfibrozil 600mg, Esomeprazol 40mg DR ,Detrol LA 2mg, Asprin EC 81mg, Lisinopril-HCTZ 10-12.5mg, Montelukast 10m

Current Illness: Diabetes 2, High Blood Pressure, Asthma, GERD, History of ulcers and colon polyps, Gastroparesis, Stage III Chronic Kidney Disease, Spinal Stenosis, herniated disc, Neuropathy, previous stroke and mini strokes

ID: 1045159
Sex: F
Age: 54
State: IL

Vax Date: 02/18/2021
Onset Date: 02/19/2021
Rec V Date: 02/22/2021
Hospital:

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

Lab Data:

Allergies: Too many to list

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Fever 104.0, painful swelling of lymph nodes in neck and under both arms and in chest

Other Meds: None

Current Illness: None

ID: 1045160
Sex: M
Age: 65
State:

Vax Date: 02/02/2021
Onset Date: 02/02/2021
Rec V Date: 02/22/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Continuing redness - rash - just below the vaccine site; at this point, 19 days after the 1st dose

Other Meds: None

Current Illness:

ID: 1045162
Sex: F
Age: 36
State: NM

Vax Date: 02/05/2021
Onset Date: 02/12/2021
Rec V Date: 02/22/2021
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: None

Symptom List: Injection site erythema, Injection site pruritus, Injection site swelling, Lymph node pain, Lymphadenopathy

Symptoms: ?COVID arm? delayed cutaneous hypersensitivity; Firmness day 1-2, a lot more painful than initial injection pain, redness that increased/spread over 3 days, painful to touch, slightly raised and swollen, started really painful ? itchy days 2-5. Took photos.

Other Meds: Topiramate, Bupropion, Montelucast, amitripytiline, omeprezole, lamotrezine, norethindone

Current Illness: No

ID: 1045164
Sex: M
Age: 25
State: NV

Vax Date: 02/19/2021
Onset Date: 02/20/2021
Rec V Date: 02/22/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Unevaluable event

Symptoms: The morning after I received both vaccine shots, I posted hearing from my right ear. The first time I received the vaccine shot, the morning after, I could barely hear out of my right ear. It almost sounded like there was a clog or earwax build-up. I didn't really think much of it and it gradually went away several days later. The worst day was the next day after the vaccine and it lasted, even though in a small amount, until 3 days after. The second dose caused the same problem. The morning after the second dose of the vaccine, I lost my hearing in the same way as before. I could barely hear out of my ear, however, I was also exhausted and ended up sleeping most of the day. When I woke up in the afternoon, I couldn't hear from my right ear, but I could hear better. (maybe 25% back to normal). The two days after the vaccine, my hearing came back way better than the previous time. It felt like 80% back to normal and later in the today, it felt like it up to 95% back to normal. The best way I can describe the feeling was as if the sound was still being received to my hear, but it sounded muffled and turned down. I was still able to hear the deeper sounds during conversations and deeper 'beats' in music, but the sharpness of everything was turned off.

Other Meds: None

Current Illness: None

ID: 1045165
Sex: M
Age: 42
State: LA

Vax Date: 01/28/2021
Onset Date: 01/29/2021
Rec V Date: 02/22/2021
Hospital: Y

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: None known

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

Symptoms: Severe Anaphylaxis onset at 3:00am. Epinephrine administered at home. Transported to ER. BP 80/40 at admission. 2nd Epinephrine administered at ER. IV fluids. BP recovered and discharged at 7:30am. Prescribed Prednisone 20mg, Famotidine 20mg, and Cetirizine 10mg.

Other Meds: Amlodipine 5mg 1/day Losartan 50mg 1/day Adderall 20mg 1/day Ibuprofen

Current Illness: None

ID: 1045166
Sex: F
Age: 49
State: AK

Vax Date: 02/13/2021
Onset Date: 02/21/2021
Rec V Date: 02/22/2021
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: Dander allergies, possible hay and other outside allergens (minor).

Symptom List: Injection site pain, Pain

Symptoms: Itchy rash near the injection site appeared 2/21/21. 2 1/2 inches long, 2 inches wide. There is still a faint pink border as to where the edges of the bandaid were (noted on the V-safe site of redness where bandaid was - no pain or itchiness symptoms at that time). The upper part of the rash touches the lower part of the pink bandaid outline. Bandaid outline still has no pain or itchiness. This symptom did not occur until after all the V-safe checking were complete. I have taken a Claritin and put anti itch cream on the site. At this point I do not have enough concern to notify a doctor. I will contact Teledoc if the rash spreads further or adversely changes in any other ways.

Other Meds: Women?s 1aday, magnesium, B12, C, D, Claritin

Current Illness: NA

ID: 1045167
Sex: M
Age: 24
State: TX

Vax Date: 02/21/2021
Onset Date: 02/22/2021
Rec V Date: 02/22/2021
Hospital:

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

Lab Data:

Allergies: N/A

Symptom List: Injection site pain, Menorrhagia

Symptoms: Pain in arm spreading throughout first few hours, by 14 hours post vaccination hives began appearing with increased intensity and number. By 15 hours post vaccination a mild headache and low fever of 100.8 developed. Treatment included diphenhydramine to ease antihistamine response and aspirin to lower fever and reduce severity of headache.

Other Meds: Diphenhydramine

Current Illness: N/A

ID: 1045169
Sex: M
Age: 76
State: AZ

Vax Date: 02/05/2021
Onset Date: 02/19/2021
Rec V Date: 02/22/2021
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: None

Symptom List: Arthralgia, Chills, Headache, Mobility decreased, Myalgia

Symptoms: Developed quite a bit of pain in the tip of left index finger. Also, have slight numbness feeling there.

Other Meds:

Current Illness: Heart

ID: 1045170
Sex: F
Age: 70
State: WA

Vax Date: 02/19/2021
Onset Date: 02/20/2021
Rec V Date: 02/22/2021
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: Prozac

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Fever,chills,upset stomach, body aches,headache

Other Meds: Omeprazole, buspar, estrovan,multivitamin

Current Illness: None

ID: 1045171
Sex: F
Age: 44
State: AZ

Vax Date: 02/18/2021
Onset Date: 02/19/2021
Rec V Date: 02/22/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Day 1 - pain in arm where shot was administered. Day 2 - 4 - pain down arm concentrated in left arm-pit, area surrounding arm-pit and left wrist and top of hand.

Other Meds: Vitamin D, Vitamin C, multivitamin, welbutrin, pravastatin

Current Illness: none

ID: 1045172
Sex: F
Age: 50
State: FL

Vax Date: 02/19/2021
Onset Date: 02/20/2021
Rec V Date: 02/22/2021
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: Penicillin

Symptom List: Headache, Heart rate increased, Injection site erythema, Injection site pain, Injection site swelling

Symptoms: There were things that I expected, like the muscle aches, fatigue, fever. But I didn?t know I was going to get such heart palpitations. I got the shot Friday afternoon, I started noticing the palpitations Saturday afternoon, and now Sunday night they?re really bothering me. They?re almost continuous. It feels like I drank a lot of caffeine, but I haven?t.

Other Meds:

Current Illness: None

ID: 1045173
Sex: F
Age: 33
State: NY

Vax Date: 02/19/2021
Onset Date: 02/19/2021
Rec V Date: 02/22/2021
Hospital:

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

Lab Data:

Allergies: None known

Symptom List: Nausea

Symptoms: Pfizer-BioNTech COVID-19 Vaccine EUA

Other Meds:

Current Illness:

ID: 1045176
Sex: F
Age: 33
State:

Vax Date: 01/09/2021
Onset Date: 01/17/2021
Rec V Date: 02/22/2021
Hospital:

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

Lab Data:

Allergies: NONE

Symptom List: Injection site pain

Symptoms: The patient is a 34yo female seen about 1 month ago for SOB - it developed 1 week after the COVID vaccine. She was sent to Cardiology and they diagnosed her with pericarditis and she was started on scheduled NSAIDS. - Cardiology recommended ESR, CRP and CBC and they were negative. - CXR was normal - Echocardiogram was suggestive of pericarditis. Cardiology told her to follow up in 1 month is symptoms did not improve and they have not. Also she stated she has developed mild, intermittent peripheral edema that resolves without intervention but this is new. I am also ordering the cardiac MRI which the cardiologist recommended if symptoms did not improve with NSAIDs.

Other Meds: Allegra PRN Lunesta PRN MiraLax.

Current Illness: NONE

ID: 1045177
Sex: F
Age: 37
State:

Vax Date: 02/13/2021
Onset Date: 02/16/2021
Rec V Date: 02/22/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Arm with large area of redness, warmth and induration. Started 2-3 days after injection and lasted until day 7

Other Meds: APAP and Ibuprofen

Current Illness:

ID: 1045178
Sex: M
Age: 20
State:

Vax Date: 02/18/2021
Onset Date: 02/19/2021
Rec V Date: 02/22/2021
Hospital: Y

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

Lab Data:

Allergies: NONE

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

Symptoms: CHEST PAIN; SOB; ELEVATED INFLAMATORY MARKERS; ELEVATED TROPONIN; MYOCARDITIS

Other Meds: NONE

Current Illness: NONE

ID: 1045179
Sex: F
Age: 21
State: CO

Vax Date: 02/10/2021
Onset Date: 02/11/2021
Rec V Date: 02/22/2021
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: Peas, pears, apricots

Symptom List: Tremor

Symptoms: Pain at injection site began 1-2 hours after and lasted 1 week, tearing axillary pain on same side as injection began next day and lasted 1 week, chills and body aches began next day and lasted ~12 hours.

Other Meds: Zoloft, oral birth control, melatonin

Current Illness: None

ID: 1045181
Sex: F
Age: 39
State: WI

Vax Date: 02/19/2021
Onset Date: 02/19/2021
Rec V Date: 02/22/2021
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: Codeine

Symptom List: Erythema, Pruritus

Symptoms: Severe body aches Chills Fever Sweats (changed clothes 4 times because wringing wet) Severe headache Fatigue (slept for 24 hours) Vomiting Nausea Light sensitivity

Other Meds: Lexapro Levothyroxine EnLyte Arnuity Ellipta

Current Illness: Runny nose, cough, congestion - tested covid negative on February 7th - ?cold? started February 3rd

ID: 1045182
Sex: M
Age: 41
State: MN

Vax Date: 02/18/2021
Onset Date: 02/19/2021
Rec V Date: 02/22/2021
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: None

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

Symptoms: Fever @ 102 degrees F Systemic Shivering Systemic Chills Systemic Muscle Aches Headache Lightheadedness

Other Meds: None

Current Illness: None

ID: 1045471
Sex: F
Age:
State: PR

Vax Date: 01/22/2021
Onset Date: 01/22/2021
Rec V Date: 02/22/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Mild discomfort; This is a spontaneous report from a contactable consumer, the patient. A 51-years-old non-pregnant female patient received the first dose of bnt162b2 (BNT162B2, lot number: EL-1283) , via an unspecified route of administration in the left arm (at 51 years of age) on 22-JAN-2021 at 13:00 as a single dose for Covid-19 Vaccination. Medical history included hypertension and Hypothyroidism. Concomitant medication included levothyroxine sodium (SYNTHROID), hydrochlorothiazide, losartan potassium (HYZAAR). The patient had no known allergies. No other vaccines were given within 4 weeks. Prior to vaccination, the patient was not diagnosed with COVID-19. Since the vaccination the patient had not been tested for COVID-19. On 22Jan2021 at 14:30, the patient experienced mild discomfort. No treatment was given for the event. The clinical outcome of the event mild discomfort was unknown.

Other Meds: SYNTHROID; HYZAAR

Current Illness:

ID: 1045472
Sex: F
Age:
State: PR

Vax Date: 01/28/2021
Onset Date: 01/28/2021
Rec V Date: 02/22/2021
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: Fever; headache; tachycardia; left arm pain; muscle pain; stomach upset; This is a spontaneous report received from a contactable nurse (patient). A 25-year-old female patient received second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, formulation: Solution for injection and lot number: EL9282) at the age of 25 years intramuscularly to left arm on 28Jan2021 13:00 at single dose for Covid-19 immunisation in hospital. Medical history included Kyphosis. The patient had no known drug allergy (NKDA). The patient had no concomitant medications. Patient previously the first dose of BNT162B2 at the age of 25 years for Covid-19 immunisation. The patient did not receive other vaccine in four weeks. The patient was not pregnant. The patient did not have COVID prior to vaccination. The patient underwent nasal swab (antigen) test on 20Jan2021 with negative result. On 28Jan2021 16:00 the patient experienced fever, headache, tachycardia, left arm pain, muscle pain and stomach upset. Therapeutic measure was taken as a result of the events and included treatment with PANADOL 500mg. Outcome of events was recovering. No follow-up attempts are possible. No other information was reported.

Other Meds:

Current Illness:

ID: 1045510
Sex: F
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 02/22/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Heart was a little bit flippy; Been feeling very weak for several days; Arm has swelled up and went up all the way to my elbow; Arm got very red and went up all the way to my elbow; Gave me the shot at the wrong place towards the front of my arm; Fever today the highest it's been is 101.2 and is now 99.6; Very tired; Joint aches; A spontaneous report was received from a consumer, concerning a female patient of an unspecified age, who received Moderna's COVID-19 vaccine (mRNA-1273) and experienced heart was a little bit flippy, been feeling very weak for several days, fever today the highest it's been is 101.2 and is now 99.6, very tired, arm has swelled up and went up all the way to my elbow, arm got very red and went up all the way to my elbow, gave me the shot at the wrong place towards the front of my arm. Medical history included paroxysmal supraventricular tachycardia. No concomitant medication was reported. On 23-Dec-2020, prior to the onset of the events, the patient received their first of two planned doses of mRNA-1273 (lot/batch: unknown) via an unknown route for prophylaxis of COVID-19 infection. On an unknown date, after 8 days after the first shot of vaccine, the patient's heart was a little bit flippy, been feeling very weak for several days, today's fever was the highest it's been is 101.2 and is now 99.6, very tired, arm has swelled up and went up all the way to my elbow, arm got very red and went up all the way to my elbow, gave me the shot at the wrong place towards the front of my arm. Laboratory details included body temperature: 101.2 and 99.6. Treatment medication was not reported. Action taken with mRNA-1273 in response to the events were not provided. The outcome of the events, my heart was a little bit flippy, been feeling very weak for several days, fever today the highest it's been is 101.2 and is now 99.6, very tired, my arm has swelled up and went up all the way to my elbow, my arm got very red and went up all the way to my elbow were considered unknown at the time of this report. The outcome of event gave me the shot at the wrong place towards the front of my arm was considered resolved at the time of this report.; Reporter's Comments: This case concerns a female (age unknown) with PMHx of PST had Vaccine administered at inappropriate site, NS unexpected asthenia, cardiac flutter, asthenia, NS expected fever, fatigue, arthralgia, vaccination site swelling, vaccination site erythema. Adverse events occurred 8 days after first dose of mRNA-1273 (lot # 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:

ID: 1045511
Sex: F
Age: 60
State: NY

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

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

Lab Data:

Allergies:

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

Symptoms: Red swelling; Red swelling; Injection in left arm but cannot assure it was intramuscular; A spontaneous report was received from a consumer who is a 60-year-old, female patient who received Moderna's COVID-19 vaccine (mRNA-1273) and got injection in left arm but cannot assure it was intramuscular, red and swelling (injection site erythema and injection site swelling). The patient's medical history was not provided. No concomitant medications were reported. On 11 Jan 2021, the patient received their first of two planned doses of mRNA-1273 (Lot number: not provided) in the left arm for prophylaxis of COVID-19 infection. On 11 Jan 2021, after the first dose of vaccine, the patient confirmed that she was fine but had a small pinhead were the vaccine was injected and was not sure if she got the injection via intramuscularly in the left arm. On 20 Jan 2021, when patient woke up, she found with red swelling that continued to grow at the time of this report. Treatment for the event included unspecified antibiotic. Action taken with mRNA-1273 in response to the events were not provided. The outcome of the events, injection in left arm but cannot assure it was intramuscular was considered resolved on 11 Jan 2021. The outcome of events red swelling was considered not resolved and was continuing at the time o this report.; Reporter's Comments: This case concerns a 60-year-old female with a NS unexpected event of Incorrect route of product administration and NS expected events of Injection site erythema and Injection site swelling. The expected events occurred 10 days after first dose mRNA-1273 (lot # unknown). Treatment included an antibiotic. Based on current available information and temporal association between the use of the product and the start date of the associated adverse events, a causal relationship cannot be excluded.

Other Meds:

Current Illness:

ID: 1045512
Sex: U
Age:
State: OK

Vax Date:
Onset Date: 02/04/2021
Rec V Date: 02/22/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Pain in extremity

Symptoms: 0.5 mL leaked out of patient's arm; vacination site discharge; A spontaneous report was received from a pharmacist concerning a patient of unknown age and unknown gender who received the Moderna COVID-19 vaccine and experienced incorrect dose administered and Vaccination site discharge. A different nurse administered vaccine to patient and they noticed 0.5mL leak out of patient's arm. Moderna vaccine, it was a second dose, administered to just one patient. Pharmacist wants to know if they should repeat dose. Only 1 injection was involved, and Pharmacist has no patient specific information. Ok for safety to contact. HCP wants in writing. The patient's medical history was not provided. Concomitant product use was not reported by the reporter. On 04 Feb 2021, the patient received their first of two planned doses of mRNA-1273 Batch number not provided on unknown date. Prior to the onset of the symptoms, the patient received their second of two planned doses of mRNA-1273 Batch number not provided intramuscularly in the for prophylaxis of COVID-19 infection. On 04 Feb 2021, a different nurse administered vaccine to patient and they noticed 0.5mL leak out of patient's arm., the injection site leaked. Moderna vaccine was a second dose, administered to just one patient. Pharmacist wants to know if they should repeat dose. Only 1 injection was involved, and Pharmacist has no patient specific information. Ok for safety to contact. HCP wants in writing. Treatment information was not provided. Action taken with mRNA-1273 in response to the events incorrect dose administered and Vaccination site discharge was not applicable. The outcome of the event was considered as recovered on 04 Feb 2021.; Reporter's Comments: This report refers to a case of incorrect dose administered and Vaccination site discharge for mRNA-1273. There were no reported adverse events associated with this case.

Other Meds:

Current Illness:

ID: 1045513
Sex: F
Age:
State:

Vax Date: 02/03/2021
Onset Date:
Rec V Date: 02/22/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: UTI after second dose; A spontaneous report was received from healthcare professional concerning a female consumer who received Moderna's COVID-19 vaccine (mRNA-1273) and experienced UTI after second dose. The patient's medical history was not provided. No relevant concomitant medications were reported. On an unspecified date, the patient received their first of two planned doses of mRNA-1273 for prophylaxis of COVID-19 infection. On 03 Feb 2021, prior to the onset of events, the patient received their second of two planned doses of mRNA-1273 for prophylaxis of COVID-19 infection. On an unknown date, after receiving the second dose of vaccination, the patient developed UTI. Treatment included antibiotics. 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 outcome for the event, UTI after second dose 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: 1045514
Sex: F
Age: 48
State: NE

Vax Date: 01/11/2021
Onset Date: 01/28/2021
Rec V Date: 02/22/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Appendicitis pain; A spontaneous report was received from a nurse concerning a 48-year-old, female patient, who received Moderna's COVID-19 Vaccine (mRNA-1273) and experienced appendicitis pain. The patient's medical history was not provided. Concomitant medications reported included omeprazole, venlafaxine hydrochloride, trazodone and spironolactone. (batch number: 041L20A) On 11 Jan 2021, seventeen days prior to onset of the events, the patient received their first of two planned doses of mRNA-1273 (batch number: 041L20A) intramuscularly in her left arm for the prophylaxis of COVID-19 infection. On 28 Jan 2021, after the vaccine administration, the patient experienced appendicitis pain, hence on 30 Jan 2021, she underwent appendicectomy. Action taken with mRNA-1273 in response to the event was not reported. The outcome of event, appendicitis pain was considered unknown at the time of his report.; Reporter's Comments: This case of appendicitis in a 48-year-old, female patient 17 days after the administration of mRNA-1273 vaccine(batch number: 041L20A) as assessed as unlikely associated with the vaccine administration based on then natural history of the disease and based on duration and outcome (appendectomy), it was most likely an ongoing inflammatory process.

Other Meds: OMEPRAZOLE; EFFEXOR; TRAZODONE; SPIRONOLACTONE

Current Illness:

ID: 1045515
Sex: F
Age:
State:

Vax Date: 01/07/2021
Onset Date: 01/07/2021
Rec V Date: 02/22/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: vaccine was injected directly into her vein/artery; bulging veins; nail beds turned blue; A spontaneous report was received from a consumer concerning a female patient, of unknown age, who developed bulging veins and nail beds turned blue after receiving a first dose of Moderna's COVID-19 vaccine administered directly into her vein/artery. The patient's medical history was not provided. No relevant concomitant medications were reported. On 07-JAN-2021 prior to the onset of the events, patient received their first of two planned doses of mRNA-1273 (Lot number: Unknown) unknown route of administration. On 03-FEB-2021, patient received their second of two planned doses of mRNA-1273 (Lot number: unknown) unknown route of administration for prophylaxis of COVID-19 infection. The patient was administered mRNA-1273 vaccine directly into vein/artery, on 07-JAN-2021, and developed bulging veins and nail beds turned blue. Treatment for the event included ice pad. EMTs checked blood pressure and monitor the patient for several minutes. There was no change planned to the dosing schedule of mRNA-1273 in response to the event. The patient received both scheduled dose of mRNA-1273; therefore, action taken with the drug in response to the event is not applicable. The event, vaccine administered directly into vein/artery was considered resolved. The outcome for the event bulging veins and nail beds turned blue not provided. .; 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. Very limited information regarding these events has been provided at this time. Further information is requested.

Other Meds:

Current Illness:

ID: 1045516
Sex: F
Age:
State: CA

Vax Date: 01/20/2021
Onset Date: 02/03/2021
Rec V Date: 02/22/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Vomiting

Symptoms: Breast cancer; A spontaneous report was received on 05 Feb 2021 from a consumer concerning an unknown age, female patient who received Moderna's COVID-19 vaccine and diagnosed with breast cancer. The patient's medical history was not provided. No relevant concomitant medications were reported. On 20 Jan 2021, patient received their first of two planned doses of mRNA-1273(Lot number: unknown), for the prophylaxis of COVID-19 infection. On 03 Feb 2021, the patient was diagnosed with breast cancer. Action taken the second dose of mRNA-1273 in response to the events was not reported. The outcome of the event, breast cancer was not resolved. The assessment of the causality by reporter was, there was no relation between the vaccine and the diagnosis of cancer, but as the event occurred after the administration of the Moderna COVID-19 vaccine.; Reporter's Comments: Based on the current available information, the event was diagnosed 15 days after the administration of mRNA-1273. Due to the nature of development of breast cancer, the event was assessed as unlikely related. Further information has been requested.

Other Meds:

Current Illness:

ID: 1045517
Sex: M
Age:
State: NE

Vax Date: 02/03/2021
Onset Date: 02/04/2021
Rec V Date: 02/22/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Sharp pains in feet (neuropathy); Bad diarrhea; Felt yucky and not feeling good at all; Arm swollen on the same side of injection; A spontaneous report was received from a consumer who was also a male patient who received Moderna's COVID-19 vaccine (mRNA-1273) and who experienced sharp pains in feet (neuropathy)/ neuropathy peripheral, arm swollen on same side of injection/ injection site swelling, bad diarrhea/ diarrhea, and feeling yucky and not good at all/ malaise. The patient's medical history was not provided. No relevant concomitant medications were reported. On 03 Feb 2021, approximately at 12:00 pm, the patient received their first of two planned doses of mRNA-1273 (Lot number: 010M20A) intramuscularly for prophylaxis of COVID-19 infection. On 04 Feb 2021, the patient started experiencing symptoms of sharp pains in his feet (neuropathy), bad diarrhea, felt yucky and not feeling good at all. On 05 Feb 2021, the patient reported that the symptoms did not abate, however they were improving. No treatment information was provided. Action taken with mRNA-1273 in response to the events was not provided. The outcome for the events, sharp pains in feet (neuropathy), arm swollen on same side of injection, bad diarrhea and felt yucky and not good at all, was resolving.; Reporter's Comments: Based on the current available information and a temporal association between the use of the product and the onset of the reported events a causal relationship cannot be excluded. Injection site swelling is consistent with the known safety profile of the vaccine.

Other Meds:

Current Illness:

ID: 1045518
Sex: F
Age:
State: NJ

Vax Date: 01/22/2021
Onset Date: 01/22/2021
Rec V Date: 02/22/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Something occurred in the syringe that not the 0.5 mL entered her arm and part spilt out; Something occurred in the syringe that not the 0.5 mL entered her arm and part spilt out; A spontaneous/solicited report was received from a consumer concerning herself, a 76 year-old, female patient who received Moderna's COVID-19 vaccine (mRNA-1273) and reported that something occurred in the syringe so that the 0.5 mL did not enter her arm and part spilt out/device connection issue and underdose. The patient's medical history included breast cancer and cholesterol (not further specified). Products known to have been used by the patient, within two weeks prior to the event, included medicine for blood pressure (not further specified), vitamins, atorvastatin calcium and nebivolol hydrochloride. On 22 Jan 2021, the patient received their first of two planned doses of mRNA-1273 (Batch number: 026L20A) intramuscularly for prophylaxis of COVID-19 infection. On 22 Jan 2021, during administration, the patient reported that something occurred in the syringe so that the 0.5 mL did not enter her arm and part spilt out. No treatment information was provided. The second dose of mRNA-1273 was scheduled for 18 Feb 2021. Action taken with mRNA-1273 in response to the events was not reported. The events, something occurred in the syringe so that the 0.5 mL did not enter her arm and part spilt out, were considered resolved on 22 Jan 2021.; Reporter's Comments: This report refers to a case of incorrect dose administered, and underdose for mRNA-1273, lot # 026L20A with no associated AEs.

Other Meds: VITAMINS NOS; LIPITOR; BYSTOLIC

Current Illness:

ID: 1045519
Sex: F
Age: 71
State: TX

Vax Date: 01/27/2021
Onset Date: 01/27/2021
Rec V Date: 02/22/2021
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: Warm to the touch injection site; Bruise on injection site; Itching left arm injection site; Redness on the side of the injection site; Pain left arm (with movement); Urinary tract infection; Headache; A spontaneous report was received from a consumer, concerning herself, a 71-year-old, female patient who received Moderna's COVID-19 Vaccine (mRNA-1273) and developed urinary tract infection, warm to the touch injection site, pain left arm (with movement), bruise on injection site, itching left arm injection site, headache and redness on the side of the injection site. The patient's medical history provided included cystitis. Concomitant product use was not provided by the reporter. On 27 Jan 2021, the patient received their first of two planned doses of mRNA-1273 (Lot # 004M20A) intramuscularly in the left arm for prophylaxis of COVID-19 infection. On 27 Jan 2021, after the first dose of vaccine administration, the patient developed headache. On 03 Feb 2021 (Wednesday) the patient experienced urinary tract infection and took one capsule of cephalexin 500mg. Later, on 04 Feb 2021, the patient's left arm of injection site had started itching and her arm was hurt on movement. When she checked in the mirror, she noticed a bruise on injection site and the side of the injection site was red and also was little warm to the touch. She thought the skin reaction might have been triggered by the cephalexin, hence she did not continue the antibiotic, but she also confirmed that she had no reactions anywhere else on the body. Action taken with mRNA-1273 in response to the events were unknown. The outcome of event, headache was considered to be resolved on 28 Jan 2021. The outcome of the events, urinary tract infection, warm to the touch injection site, pain left arm (with movement), bruise on injection site, itching left arm injection site and redness on the side of the injection site were considered unknown at the time of this report.; Reporter's Comments: Based on the current information and temporal association between the use of the product and the start date of these events, a causal relationship cannot be excluded. Patient's medical history of cystitis is a confounder for urinary tract infection.

Other Meds:

Current Illness:

ID: 1045520
Sex: F
Age: 84
State: MI

Vax Date: 01/28/2021
Onset Date: 02/05/2021
Rec V Date: 02/22/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Possible cellulitis; left arm stiff; itchy redness on the area of injection; itchy redness on the area of injection; A spontaneous report was received from consumer concerning a 84-year-old female patient who received Moderna's COVID-19 vaccine (mRNA-1273) and experienced itchy redness the injection site on her left arm, her left arm is stiff, and possible cellulitis. The patient's medical history and concomitant product use were not provided. On 28-Jan-2021, the patient received the first of two planned doses of mRNA-1273, (Lot number 007M20A), intramuscularly into her left arm for prophylaxis of Covid-19 infection. On the morning of 05-Feb-2021 the patient noticed, itchy redness, 4X6 inches in size, 4 inches below the injection site on her left arm and her left arm is stiff. The patient was examined by her doctor that same day and was prescribed Doxycycline for a possible cellulitis. No relevant laboratory tests were ordered. Action taken with mRNA-1273 in response to the event was not provided. The outcome of the events, itchy redness, 4X6 inches in size, 4 inches below the injection site on her left arm and her left arm is stiff and possible cellulitis were unknown.; Reporter's Comments: This case concerns an 84-year-old female who experienced a serious unexpected event of cellulitis along with a NS unexpected events of stiffness and injection site pruritus and NS expected event of injection site erythema. The events occurred 9 days after the first dose of mRNA-1273. Treatment included doxycycline. 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.

Other Meds:

Current Illness:

ID: 1045521
Sex: F
Age: 83
State: IL

Vax Date: 02/04/2021
Onset Date: 02/04/2021
Rec V Date: 02/22/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Fainted; Diarrhea; Nausea; Warm body temperature; A spontaneous report was received from a consumer, regarding herself, a 82-year-old, female consumer who received Moderna's COVID-19 vaccine (mRNA-1273) and experienced fainted, diarrhea, nausea and warm body temperature. The patient's medical history reported included ulcerative colitis. Concomitant product use was not provided. On 04 Feb 2021, prior to the onset of the events, the patient received their first of two planned doses of mRNA-1273 (lot Number: 038K20A) intramuscularly for prophylaxis of COVID-19 infection. On 04 Feb 2021, in the evening, after receiving the vaccine, the patient was fainted and started to experience diarrhea, nausea and warm body temperature. The event fainted was considered to be medically significant. Treatment for the events not provided. Action taken with the second dose of mRNA-1273 in response to the events were not reported. The outcome for the events, fainted, diarrhea, nausea and warm body temperature were resolved on 05 Feb 2021.; Reporter's Comments: Based on the current available information and temporal association between the use of the product and the onset date of the events, a causal relationship cannot be excluded.

Other Meds:

Current Illness: Ulcerative colitis

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm