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: 0945862
Sex: U
Age:
State: NM

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

Lab Data:

Allergies:

Symptoms: Vaccine was stored at -20 Degrees F so outside of the Temperature range; A spontaneous report was received from a pharmacist concerning a patient who received Moderna's COVID-19 vaccine (mRNA-1273) that was stored at -20 degrees F, so outside of the temperature range. The patient's medical history was not provided. No relevant concomitant medications were reported. On an unknown date, the patient received their first of two planned doses of mRNA-1273 intramuscularly for prophylaxis of COVID-19 infection. The reporter stated the COVID-19 vaccine was stored at -20 degrees Fahrenheit; outside of the recommended temperature range. No treatment information was provided. Action taken with mRNA-1273 in response to the event was not reported. The event, vaccine that was stored at -20 degrees F so outside of the temperature range, was considered resolved.; Reporter's Comments: This case concerns a patient who received their first of two planned doses of mRNA-1273 (Lot unknown), reporting Product storage error without any associated adverse events.

Other Meds:

Current Illness:

ID: 0945863
Sex: U
Age:
State: NM

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

Lab Data:

Allergies:

Symptoms: A spontaneous report was received from a pharmacist concerning a patient who received Moderna's COVID-19 vaccine (mRNA-1273) that was stored at -20 degrees F, so outside of the temperature range. The patient's medical history was not provided. No relevant concomitant medications were reported. On an unknown date, the patient received their first of two planned doses of mRNA-1273 intramuscularly for prophylaxis of COVID-19 infection. The reporter stated the COVID-19 vaccine was stored at -20 degrees Fahrenheit; outside of the recommended temperature range. No treatment information was provided. Action taken with mRNA-1273 in response to the event was not reported. The event, vaccine that was stored at -20 degrees F so outside of the temperature range, was considered resolved.; Reporter's Comments: This case concerns a patient who received their first of two planned doses of mRNA-1273 (Lot unknown), reporting Product storage error without any associated adverse events.

Other Meds:

Current Illness:

ID: 0945864
Sex: U
Age:
State: NM

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

Lab Data:

Allergies:

Symptoms: Vaccine was stored at -20 Degrees F so outside of the Temperature range; A spontaneous report was received from a pharmacist concerning a patient who received Moderna's COVID-19 vaccine (mRNA-1273) that was stored at -20 degrees F, so outside of the temperature range. The patient's medical history was not provided. No relevant concomitant medications were reported. On an unknown date, the patient received their first of two planned doses of mRNA-1273 intramuscularly for prophylaxis of COVID-19 infection. The reporter stated the COVID-19 vaccine was stored at -20 degrees Fahrenheit; outside of the recommended temperature range. No treatment information was provided. Action taken with mRNA-1273 in response to the event was not reported. The event, vaccine that was stored at -20 degrees F so outside of the temperature range, was considered resolved.; Reporter's Comments: This case concerns a patient who received their first of two planned doses of mRNA-1273 (Lot unknown), reporting Product storage error without any associated adverse events.

Other Meds:

Current Illness:

ID: 0945865
Sex: U
Age:
State: NM

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

Lab Data:

Allergies:

Symptoms: Vaccine was stored at -20 Degrees F so outside of the Temperature range; A spontaneous report was received from a pharmacist concerning a patient who received Moderna's COVID-19 vaccine (mRNA-1273) that was stored at -20 degrees F, so outside of the temperature range. The patient's medical history was not provided. No relevant concomitant medications were reported. On an unknown date, the patient received their first of two planned doses of mRNA-1273 intramuscularly for prophylaxis of COVID-19 infection. The reporter stated the COVID-19 vaccine was stored at -20 degrees Fahrenheit; outside of the recommended temperature range. No treatment information was provided. Action taken with mRNA-1273 in response to the event was not reported. The event, vaccine that was stored at -20 degrees F so outside of the temperature range, was considered resolved.; Reporter's Comments: This case concerns a patient who received their first of two planned doses of mRNA-1273 (Lot unknown), reporting Product storage error without any associated adverse events.

Other Meds:

Current Illness:

ID: 0945866
Sex: U
Age:
State: NM

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

Lab Data:

Allergies:

Symptoms: Vaccine was stored at -20 Degrees F so outside of the Temperature range; A spontaneous report was received from a pharmacist concerning a patient who received Moderna's COVID-19 vaccine (mRNA-1273) that was stored at -20 degrees F, so outside of the temperature range. The patient's medical history was not provided. No relevant concomitant medications were reported. On an unknown date, the patient received their first of two planned doses of mRNA-1273 intramuscularly for prophylaxis of COVID-19 infection. The reporter stated the COVID-19 vaccine was stored at -20 degrees Fahrenheit; outside of the recommended temperature range. No treatment information was provided. Action taken with mRNA-1273 in response to the event was not reported. The event, vaccine that was stored at -20 degrees F so outside of the temperature range, was considered resolved.; Reporter's Comments: This case concerns a patient who received their first of two planned doses of mRNA-1273 (Lot unknown), reporting Product storage error without any associated adverse events.

Other Meds:

Current Illness:

ID: 0945867
Sex: U
Age:
State: NM

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

Lab Data:

Allergies:

Symptoms: Vaccine was stored at -20 Degrees F so outside of the Temperature range; A spontaneous report was received from a pharmacist concerning a patient who received Moderna's COVID-19 vaccine (mRNA-1273) that was stored at -20 degrees F, so outside of the temperature range. The patient's medical history was not provided. No relevant concomitant medications were reported. On an unknown date, the patient received their first of two planned doses of mRNA-1273 intramuscularly for prophylaxis of COVID-19 infection. The reporter stated the COVID-19 vaccine was stored at -20 degrees Fahrenheit; outside of the recommended temperature range. No treatment information was provided. Action taken with mRNA-1273 in response to the event was not reported. The event, vaccine that was stored at -20 degrees F so outside of the temperature range, was considered resolved.; Reporter's Comments: This case concerns a patient who received their first of two planned doses of mRNA-1273 (Lot unknown), reporting Product storage error without any associated adverse events.

Other Meds:

Current Illness:

ID: 0945868
Sex: U
Age:
State: NM

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

Lab Data:

Allergies:

Symptoms: A spontaneous report was received from a pharmacist concerning a patient who received Moderna's COVID-19 vaccine (mRNA-1273) that was stored at -20 degrees F, so outside of the temperature range. The patient's medical history was not provided. No relevant concomitant medications were reported. On an unknown date, the patient received their first of two planned doses of mRNA-1273 intramuscularly for prophylaxis of COVID-19 infection. The reporter stated the COVID-19 vaccine was stored at -20 degrees Fahrenheit; outside of the recommended temperature range. No treatment information was provided. Action taken with mRNA-1273 in response to the event was not reported. The event, vaccine that was stored at -20 degrees F so outside of the temperature range, was considered resolved.; Reporter's Comments: This case concerns a patient who received their first of two planned doses of mRNA-1273 (Lot unknown), reporting Product storage error without any associated adverse events.

Other Meds:

Current Illness:

ID: 0945869
Sex: U
Age:
State: NM

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

Lab Data:

Allergies:

Symptoms: Vaccine was stored at -20 Degrees F so outside of the Temperature range; A spontaneous report was received from a pharmacist concerning a patient who received Moderna's COVID-19 vaccine (mRNA-1273) that was stored at -20 degrees F, so outside of the temperature range. The patient's medical history was not provided. No relevant concomitant medications were reported. On an unknown date, the patient received their first of two planned doses of mRNA-1273 intramuscularly for prophylaxis of COVID-19 infection. The reporter stated the COVID-19 vaccine was stored at -20 degrees Fahrenheit; outside of the recommended temperature range. No treatment information was provided. Action taken with mRNA-1273 in response to the event was not reported. The event, vaccine that was stored at -20 degrees F so outside of the temperature range, was considered resolved.; Reporter's Comments: This case concerns a patient who received their first of two planned doses of mRNA-1273 (Lot unknown), reporting Product storage error without any associated adverse events.

Other Meds:

Current Illness:

ID: 0945870
Sex: U
Age:
State: NM

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

Lab Data:

Allergies:

Symptoms: Vaccine was stored at -20 Degrees F so outside of the Temperature range; A spontaneous report was received from a pharmacist concerning a patient who received Moderna's COVID-19 vaccine (mRNA-1273) that was stored at -20 degrees F, so outside of the temperature range. The patient's medical history was not provided. No relevant concomitant medications were reported. On an unknown date, the patient received their first of two planned doses of mRNA-1273 intramuscularly for prophylaxis of COVID-19 infection. The reporter stated the COVID-19 vaccine was stored at -20 degrees Fahrenheit; outside of the recommended temperature range. No treatment information was provided. Action taken with mRNA-1273 in response to the event was not reported. The event, vaccine that was stored at -20 degrees F so outside of the temperature range, was considered resolved.; Reporter's Comments: This case concerns a patient who received their first of two planned doses of mRNA-1273 (Lot unknown), reporting Product storage error without any associated adverse events.

Other Meds:

Current Illness:

ID: 0945871
Sex: U
Age:
State: NM

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

Lab Data:

Allergies:

Symptoms: Vaccine was stored at -20 Degrees F so outside of the Temperature range; A spontaneous report was received from a pharmacist concerning a patient who received Moderna's COVID-19 vaccine (mRNA-1273) that was stored at -20 degrees F, so outside of the temperature range. The patient's medical history was not provided. No relevant concomitant medications were reported. On an unknown date, the patient received their first of two planned doses of mRNA-1273 intramuscularly for prophylaxis of COVID-19 infection. The reporter stated the COVID-19 vaccine was stored at -20 degrees Fahrenheit; outside of the recommended temperature range. No treatment information was provided. Action taken with mRNA-1273 in response to the event was not reported. The event, vaccine that was stored at -20 degrees F so outside of the temperature range, was considered resolved.; Reporter's Comments: This case concerns a patient who received their first of two planned doses of mRNA-1273 (Lot unknown), reporting Product storage error without any associated adverse events.

Other Meds:

Current Illness:

ID: 0945872
Sex: U
Age:
State: NM

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

Lab Data:

Allergies:

Symptoms: Vaccine was stored at -20 Degrees F so outside of the Temperature range; A spontaneous report was received from a pharmacist concerning a patient who received Moderna's COVID-19 vaccine (mRNA-1273) that was stored at -20 degrees F, so outside of the temperature range. The patient's medical history was not provided. No relevant concomitant medications were reported. On an unknown date, the patient received their first of two planned doses of mRNA-1273 intramuscularly for prophylaxis of COVID-19 infection. The reporter stated the COVID-19 vaccine was stored at -20 degrees Fahrenheit; outside of the recommended temperature range. No treatment information was provided. Action taken with mRNA-1273 in response to the event was not reported. The event, vaccine that was stored at -20 degrees F so outside of the temperature range, was considered resolved.; Reporter's Comments: This case concerns a patient who received their first of two planned doses of mRNA-1273 (Lot unknown), reporting Product storage error without any associated adverse events.

Other Meds:

Current Illness:

ID: 0945873
Sex: U
Age:
State: NM

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

Lab Data:

Allergies:

Symptoms: Vaccine was stored at -20 Degrees F so outside of the Temperature range; A spontaneous report was received from a pharmacist concerning a patient who received Moderna's COVID-19 vaccine (mRNA-1273) that was stored at -20 degrees F, so outside of the temperature range. The patient's medical history was not provided. No relevant concomitant medications were reported. On an unknown date, the patient received their first of two planned doses of mRNA-1273 intramuscularly for prophylaxis of COVID-19 infection. The reporter stated the COVID-19 vaccine was stored at -20 degrees Fahrenheit; outside of the recommended temperature range. No treatment information was provided. Action taken with mRNA-1273 in response to the event was not reported. The event, vaccine that was stored at -20 degrees F so outside of the temperature range, was considered resolved.; Reporter's Comments: This case concerns a patient who received their first of two planned doses of mRNA-1273 (Lot unknown), reporting Product storage error without any associated adverse events.

Other Meds:

Current Illness:

ID: 0945874
Sex: U
Age:
State: NM

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

Lab Data:

Allergies:

Symptoms: Vaccine was stored at -20 Degrees F so outside of the Temperature range; A spontaneous report was received from a pharmacist concerning a patient who received Moderna's COVID-19 vaccine (mRNA-1273) that was stored at -20 degrees F, so outside of the temperature range. The patient's medical history was not provided. No relevant concomitant medications were reported. On an unknown date, the patient received their first of two planned doses of mRNA-1273 intramuscularly for prophylaxis of COVID-19 infection. The reporter stated the COVID-19 vaccine was stored at -20 degrees Fahrenheit; outside of the recommended temperature range. No treatment information was provided. Action taken with mRNA-1273 in response to the event was not reported. The event, vaccine that was stored at -20 degrees F so outside of the temperature range, was considered resolved.; Reporter's Comments: This case concerns a patient who received their first of two planned doses of mRNA-1273 (Lot unknown), reporting Product storage error without any associated adverse events.

Other Meds:

Current Illness:

ID: 0945875
Sex: U
Age:
State: NM

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

Lab Data:

Allergies:

Symptoms: Vaccine was stored at -20 Degrees F so outside of the Temperature range; A spontaneous report was received from a pharmacist concerning a patient who received Moderna's COVID-19 vaccine (mRNA-1273) that was stored at -20 degrees F, so outside of the temperature range. The patient's medical history was not provided. No relevant concomitant medications were reported. On an unknown date, the patient received their first of two planned doses of mRNA-1273 intramuscularly for prophylaxis of COVID-19 infection. The reporter stated the COVID-19 vaccine was stored at -20 degrees Fahrenheit; outside of the recommended temperature range. No treatment information was provided. Action taken with mRNA-1273 in response to the event was not reported. The event, vaccine that was stored at -20 degrees F so outside of the temperature range, was considered resolved.; Reporter's Comments: This case concerns a patient who received their first of two planned doses of mRNA-1273 (Lot unknown), reporting Product storage error without any associated adverse events.

Other Meds:

Current Illness:

ID: 0945876
Sex: U
Age:
State: NM

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

Lab Data:

Allergies:

Symptoms: Vaccine was stored at -20 Degrees F so outside of the Temperature range; A spontaneous report was received from a pharmacist concerning a patient who received Moderna's COVID-19 vaccine (mRNA-1273) that was stored at -20 degrees F, so outside of the temperature range. The patient's medical history was not provided. No relevant concomitant medications were reported. On an unknown date, the patient received their first of two planned doses of mRNA-1273 intramuscularly for prophylaxis of COVID-19 infection. The reporter stated the COVID-19 vaccine was stored at -20 degrees Fahrenheit; outside of the recommended temperature range. No treatment information was provided. Action taken with mRNA-1273 in response to the event was not reported. The event, vaccine that was stored at -20 degrees F so outside of the temperature range, was considered resolved.; Reporter's Comments: This case concerns a patient who received their first of two planned doses of mRNA-1273 (Lot unknown), reporting Product storage error without any associated adverse events.

Other Meds:

Current Illness:

ID: 0945877
Sex: U
Age:
State: NM

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

Lab Data:

Allergies:

Symptoms: Vaccine was stored at -20 Degrees F so outside of the Temperature range; A spontaneous report was received from a pharmacist concerning a patient who received Moderna's COVID-19 vaccine (mRNA-1273) that was stored at -20 degrees F, so outside of the temperature range. The patient's medical history was not provided. No relevant concomitant medications were reported. On an unknown date, the patient received their first of two planned doses of mRNA-1273 intramuscularly for prophylaxis of COVID-19 infection. The reporter stated the COVID-19 vaccine was stored at -20 degrees Fahrenheit; outside of the recommended temperature range. No treatment information was provided. Action taken with mRNA-1273 in response to the event was not reported. The event, vaccine that was stored at -20 degrees F so outside of the temperature range, was considered resolved.; Reporter's Comments: This case concerns a patient who received their first of two planned doses of mRNA-1273 (Lot unknown), reporting Product storage error without any associated adverse events.

Other Meds:

Current Illness:

ID: 0945878
Sex: U
Age:
State: NM

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

Lab Data:

Allergies:

Symptoms: Vaccine was stored at -20 Degrees F so outside of the Temperature range; A spontaneous report was received from a pharmacist concerning a patient who received Moderna's COVID-19 vaccine (mRNA-1273) that was stored at -20 degrees F, so outside of the temperature range. The patient's medical history was not provided. No relevant concomitant medications were reported. On an unknown date, the patient received their first of two planned doses of mRNA-1273 intramuscularly for prophylaxis of COVID-19 infection. The reporter stated the COVID-19 vaccine was stored at -20 degrees Fahrenheit; outside of the recommended temperature range. No treatment information was provided. Action taken with mRNA-1273 in response to the event was not reported. The event, vaccine that was stored at -20 degrees F so outside of the temperature range, was considered resolved.; Reporter's Comments: This case concerns a patient who received their first of two planned doses of mRNA-1273 (Lot unknown), reporting Product storage error without any associated adverse events.

Other Meds:

Current Illness:

ID: 0945879
Sex: U
Age:
State: NM

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

Lab Data:

Allergies:

Symptoms: Vaccine was stored at -20 Degrees F so outside of the Temperature range; A spontaneous report was received from a pharmacist concerning a patient who received Moderna's COVID-19 vaccine (mRNA-1273) that was stored at -20 degrees F, so outside of the temperature range. The patient's medical history was not provided. No relevant concomitant medications were reported. On an unknown date, the patient received their first of two planned doses of mRNA-1273 intramuscularly for prophylaxis of COVID-19 infection. The reporter stated the COVID-19 vaccine was stored at -20 degrees Fahrenheit; outside of the recommended temperature range. No treatment information was provided. Action taken with mRNA-1273 in response to the event was not reported. The event, vaccine that was stored at -20 degrees F so outside of the temperature range, was considered resolved.; Reporter's Comments: This case concerns a patient who received their first of two planned doses of mRNA-1273 (Lot unknown), reporting Product storage error without any associated adverse events.

Other Meds:

Current Illness:

ID: 0945880
Sex: U
Age:
State: NM

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

Lab Data:

Allergies:

Symptoms: Vaccine was stored at -20 Degrees F so outside of the Temperature range; A spontaneous report was received from a pharmacist concerning a patient who received Moderna's COVID-19 vaccine (mRNA-1273) that was stored at -20 degrees F, so outside of the temperature range. The patient's medical history was not provided. No relevant concomitant medications were reported. On an unknown date, the patient received their first of two planned doses of mRNA-1273 intramuscularly for prophylaxis of COVID-19 infection. The reporter stated the COVID-19 vaccine was stored at -20 degrees Fahrenheit; outside of the recommended temperature range. No treatment information was provided. Action taken with mRNA-1273 in response to the event was not reported. The event, vaccine that was stored at -20 degrees F so outside of the temperature range, was considered resolved.; Reporter's Comments: This case concerns a patient who received their first of two planned doses of mRNA-1273 (Lot unknown), reporting Product storage error without any associated adverse events.

Other Meds:

Current Illness:

ID: 0945881
Sex: U
Age:
State: NM

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

Lab Data:

Allergies:

Symptoms: Vaccine was stored at -20 Degrees F so outside of the Temperature range; A spontaneous report was received from a pharmacist concerning a patient who received Moderna's COVID-19 vaccine (mRNA-1273) that was stored at -20 degrees F, so outside of the temperature range. The patient's medical history was not provided. No relevant concomitant medications were reported. On an unknown date, the patient received their first of two planned doses of mRNA-1273 intramuscularly for prophylaxis of COVID-19 infection. The reporter stated the COVID-19 vaccine was stored at -20 degrees Fahrenheit; outside of the recommended temperature range. No treatment information was provided. Action taken with mRNA-1273 in response to the event was not reported. The event, vaccine that was stored at -20 degrees F so outside of the temperature range, was considered resolved.; Reporter's Comments: This case concerns a patient who received their first of two planned doses of mRNA-1273 (Lot unknown), reporting Product storage error without any associated adverse events.

Other Meds:

Current Illness:

ID: 0945882
Sex: U
Age:
State: NM

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

Lab Data:

Allergies:

Symptoms: Vaccine was stored at -20 Degrees F so outside of the Temperature range; A spontaneous report was received from a pharmacist concerning a patient who received Moderna's COVID-19 vaccine (mRNA-1273) that was stored at -20 degrees F, so outside of the temperature range. The patient's medical history was not provided. No relevant concomitant medications were reported. On an unknown date, the patient received their first of two planned doses of mRNA-1273 intramuscularly for prophylaxis of COVID-19 infection. The reporter stated the COVID-19 vaccine was stored at -20 degrees Fahrenheit; outside of the recommended temperature range. No treatment information was provided. Action taken with mRNA-1273 in response to the event was not reported. The event, vaccine that was stored at -20 degrees F so outside of the temperature range, was considered resolved.; Reporter's Comments: This case concerns a patient who received their first of two planned doses of mRNA-1273 (Lot unknown), reporting Product storage error without any associated adverse events.

Other Meds:

Current Illness:

ID: 0945883
Sex: U
Age:
State: NM

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

Lab Data:

Allergies:

Symptoms: Vaccine was stored at -20 Degrees F so outside of the Temperature range; A spontaneous report was received from a pharmacist concerning a patient who received Moderna's COVID-19 vaccine (mRNA-1273) that was stored at -20 degrees F, so outside of the temperature range. The patient's medical history was not provided. No relevant concomitant medications were reported. On an unknown date, the patient received their first of two planned doses of mRNA-1273 intramuscularly for prophylaxis of COVID-19 infection. The reporter stated the COVID-19 vaccine was stored at -20 degrees Fahrenheit; outside of the recommended temperature range. No treatment information was provided. Action taken with mRNA-1273 in response to the event was not reported. The event, vaccine that was stored at -20 degrees F so outside of the temperature range, was considered resolved.; Reporter's Comments: This case concerns a patient who received their first of two planned doses of mRNA-1273 (Lot unknown), reporting Product storage error without any associated adverse events.

Other Meds:

Current Illness:

ID: 0945884
Sex: U
Age:
State: NM

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

Lab Data:

Allergies:

Symptoms: Vaccine was stored at -20 Degrees F so outside of the Temperature range; A spontaneous report was received from a pharmacist concerning a patient who received Moderna's COVID-19 vaccine (mRNA-1273) that was stored at -20 degrees F, so outside of the temperature range. The patient's medical history was not provided. No relevant concomitant medications were reported. On an unknown date, the patient received their first of two planned doses of mRNA-1273 intramuscularly for prophylaxis of COVID-19 infection. The reporter stated the COVID-19 vaccine was stored at -20 degrees Fahrenheit; outside of the recommended temperature range. No treatment information was provided. Action taken with mRNA-1273 in response to the event was not reported. The event, vaccine that was stored at -20 degrees F so outside of the temperature range, was considered resolved.; Reporter's Comments: This case concerns a patient who received their first of two planned doses of mRNA-1273 (Lot unknown), reporting Product storage error without any associated adverse events.

Other Meds:

Current Illness:

ID: 0945885
Sex: U
Age:
State: NM

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

Lab Data:

Allergies:

Symptoms: Vaccine was stored at -20 Degrees F so outside of the Temperature range; A spontaneous report was received from a pharmacist concerning a patient who received Moderna's COVID-19 vaccine (mRNA-1273) that was stored at -20 degrees F, so outside of the temperature range. The patient's medical history was not provided. No relevant concomitant medications were reported. On an unknown date, the patient received their first of two planned doses of mRNA-1273 intramuscularly for prophylaxis of COVID-19 infection. The reporter stated the COVID-19 vaccine was stored at -20 degrees Fahrenheit; outside of the recommended temperature range. No treatment information was provided. Action taken with mRNA-1273 in response to the event was not reported. The event, vaccine that was stored at -20 degrees F so outside of the temperature range, was considered resolved.; Reporter's Comments: This case concerns a patient who received their first of two planned doses of mRNA-1273 (Lot unknown), reporting Product storage error without any associated adverse events.

Other Meds:

Current Illness:

ID: 0945886
Sex: U
Age:
State: NM

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

Lab Data:

Allergies:

Symptoms: Vaccine was stored at -20 Degrees F so outside of the Temperature range; A spontaneous report was received from a pharmacist concerning a patient who received Moderna's COVID-19 vaccine (mRNA-1273) that was stored at -20 degrees F, so outside of the temperature range. The patient's medical history was not provided. No relevant concomitant medications were reported. On an unknown date, the patient received their first of two planned doses of mRNA-1273 intramuscularly for prophylaxis of COVID-19 infection. The reporter stated the COVID-19 vaccine was stored at -20 degrees Fahrenheit; outside of the recommended temperature range. No treatment information was provided. Action taken with mRNA-1273 in response to the event was not reported. The event, vaccine that was stored at -20 degrees F so outside of the temperature range, was considered resolved.; Reporter's Comments: This case concerns a patient who received their first of two planned doses of mRNA-1273 (Lot unknown), reporting Product storage error without any associated adverse events.

Other Meds:

Current Illness:

ID: 0945887
Sex: U
Age:
State: NM

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

Lab Data:

Allergies:

Symptoms: Vaccine was stored at -20 Degrees F so outside of the Temperature range; A spontaneous report (United States) was received from a pharmacist concerning a patient who received Moderna's COVID-19 vaccine (mRNA-1273) that was stored at -20 degrees F, so outside of the temperature range. The patient's medical history was not provided. No relevant concomitant medications were reported. On an unknown date, the patient received their first of two planned doses of mRNA-1273 intramuscularly for prophylaxis of COVID-19 infection. The reporter stated the COVID-19 vaccine was stored at -20 degrees Fahrenheit; outside of the recommended temperature range. No treatment information was provided. Action taken with mRNA-1273 in response to the event was not reported. The event, vaccine that was stored at -20 degrees F so outside of the temperature range, was considered resolved.; Reporter's Comments: This case concerns a patient who received their first of two planned doses of mRNA-1273 (Lot unknown), reporting Product storage error without any associated adverse events.

Other Meds:

Current Illness:

ID: 0945888
Sex: U
Age:
State: NM

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

Lab Data:

Allergies:

Symptoms: Vaccine was stored at -20 Degrees F so outside of the Temperature range; A spontaneous report was received from a pharmacist concerning a patient who received Moderna's COVID-19 vaccine (mRNA-1273) that was stored at -20 degrees F, so outside of the temperature range. The patient's medical history was not provided. No relevant concomitant medications were reported. On an unknown date, the patient received their first of two planned doses of mRNA-1273 intramuscularly for prophylaxis of COVID-19 infection. The reporter stated the COVID-19 vaccine was stored at -20 degrees Fahrenheit; outside of the recommended temperature range. No treatment information was provided. Action taken with mRNA-1273 in response to the event was not reported. The event, vaccine that was stored at -20 degrees F so outside of the temperature range, was considered resolved.; Reporter's Comments: This case concerns a patient who received their first of two planned doses of mRNA-1273 (Lot unknown), reporting Product storage error without any associated adverse events.

Other Meds:

Current Illness:

ID: 0945889
Sex: U
Age:
State: NM

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

Lab Data:

Allergies:

Symptoms: A spontaneous report was received from a pharmacist concerning a patient who received Moderna's COVID-19 vaccine (mRNA-1273) that was stored at -20 degrees F, so outside of the temperature range. The patient's medical history was not provided. No relevant concomitant medications were reported. On an unknown date, the patient received their first of two planned doses of mRNA-1273 intramuscularly for prophylaxis of COVID-19 infection. The reporter stated the COVID-19 vaccine was stored at -20 degrees Fahrenheit; outside of the recommended temperature range. No treatment information was provided. Action taken with mRNA-1273 in response to the event was not reported. The event, vaccine that was stored at -20 degrees F so outside of the temperature range, was considered resolved.; Reporter's Comments: This case concerns a patient who received their first of two planned doses of mRNA-1273 (Lot unknown), reporting Product storage error without any associated adverse events.

Other Meds:

Current Illness:

ID: 0945890
Sex: U
Age:
State: NM

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

Lab Data:

Allergies:

Symptoms: A spontaneous report was received from a pharmacist concerning a patient who received Moderna's COVID-19 vaccine (mRNA-1273) that was stored at -20 degrees F, so outside of the temperature range. The patient's medical history was not provided. No relevant concomitant medications were reported. On an unknown date, the patient received their first of two planned doses of mRNA-1273 intramuscularly for prophylaxis of COVID-19 infection. The reporter stated the COVID-19 vaccine was stored at -20 degrees Fahrenheit; outside of the recommended temperature range. No treatment information was provided. Action taken with mRNA-1273 in response to the event was not reported. The event, vaccine that was stored at -20 degrees F so outside of the temperature range, was considered resolved.; Reporter's Comments: This case concerns a patient who received their first of two planned doses of mRNA-1273 (Lot unknown), reporting Product storage error without any associated adverse events.

Other Meds:

Current Illness:

ID: 0945891
Sex: U
Age:
State: NM

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

Lab Data:

Allergies:

Symptoms: Vaccine was stored at -20 Degrees F so outside of the Temperature range; A spontaneous report was received from a pharmacist concerning a patient who received Moderna's COVID-19 vaccine (mRNA-1273) that was stored at -20 degrees F, so outside of the temperature range. The patient's medical history was not provided. No relevant concomitant medications were reported. On an unknown date, the patient received their first of two planned doses of mRNA-1273 intramuscularly for prophylaxis of COVID-19 infection. The reporter stated the COVID-19 vaccine was stored at -20 degrees Fahrenheit; outside of the recommended temperature range. No treatment information was provided. Action taken with mRNA-1273 in response to the event was not reported. The event, vaccine that was stored at -20 degrees F so outside of the temperature range, was considered resolved.; Reporter's Comments: This case concerns a patient who received their first of two planned doses of mRNA-1273 (Lot unknown), reporting Product storage error without any associated adverse events.

Other Meds:

Current Illness:

ID: 0945892
Sex: U
Age:
State: NM

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

Lab Data:

Allergies:

Symptoms: Vaccine was stored at -20 Degrees F so outside of the Temperature range; A spontaneous report was received from a pharmacist concerning a patient who received Moderna's COVID-19 vaccine (mRNA-1273) that was stored at -20 degrees F, so outside of the temperature range. The patient's medical history was not provided. No relevant concomitant medications were reported. On an unknown date, the patient received their first of two planned doses of mRNA-1273 intramuscularly for prophylaxis of COVID-19 infection. The reporter stated the COVID-19 vaccine was stored at -20 degrees Fahrenheit; outside of the recommended temperature range. No treatment information was provided. Action taken with mRNA-1273 in response to the event was not reported. The event, vaccine that was stored at -20 degrees F so outside of the temperature range, was considered resolved.; Reporter's Comments: This case concerns a patient who received their first of two planned doses of mRNA-1273 (Lot unknown), reporting Product storage error without any associated adverse events.

Other Meds:

Current Illness:

ID: 0945893
Sex: U
Age:
State: NM

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

Lab Data:

Allergies:

Symptoms: Vaccine was stored at -20 Degrees F so outside of the Temperature range; A spontaneous report was received from a pharmacist concerning a patient who received Moderna's COVID-19 vaccine (mRNA-1273) that was stored at -20 degrees F, so outside of the temperature range. The patient's medical history was not provided. No relevant concomitant medications were reported. On an unknown date, the patient received their first of two planned doses of mRNA-1273 intramuscularly for prophylaxis of COVID-19 infection. The reporter stated the COVID-19 vaccine was stored at -20 degrees Fahrenheit; outside of the recommended temperature range. No treatment information was provided. Action taken with mRNA-1273 in response to the event was not reported. The event, vaccine that was stored at -20 degrees F so outside of the temperature range, was considered resolved.; Reporter's Comments: This case concerns a patient who received their first of two planned doses of mRNA-1273 (Lot unknown), reporting Product storage error without any associated adverse events.

Other Meds:

Current Illness:

ID: 0945894
Sex: U
Age:
State: NM

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

Lab Data:

Allergies:

Symptoms: Vaccine was stored at -20 Degrees F so outside of the Temperature range; A spontaneous report was received from a pharmacist concerning a patient who received Moderna's COVID-19 vaccine (mRNA-1273) that was stored at -20 degrees F, so outside of the temperature range. The patient's medical history was not provided. No relevant concomitant medications were reported. On an unknown date, the patient received their first of two planned doses of mRNA-1273 intramuscularly for prophylaxis of COVID-19 infection. The reporter stated the COVID-19 vaccine was stored at -20 degrees Fahrenheit; outside of the recommended temperature range. No treatment information was provided. Action taken with mRNA-1273 in response to the event was not reported. The event, vaccine that was stored at -20 degrees F so outside of the temperature range, was considered resolved.; Reporter's Comments: This case concerns a patient who received their first of two planned doses of mRNA-1273 (Lot unknown), reporting Product storage error without any associated adverse events.

Other Meds:

Current Illness:

ID: 0945895
Sex: U
Age:
State: NM

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

Lab Data:

Allergies:

Symptoms: Vaccine was stored at -20 Degrees F so outside of the Temperature range; A spontaneous report was received from a pharmacist concerning a patient who received Moderna's COVID-19 vaccine (mRNA-1273) that was stored at -20 degrees F, so outside of the temperature range. The patient's medical history was not provided. No relevant concomitant medications were reported. On an unknown date, the patient received their first of two planned doses of mRNA-1273 intramuscularly for prophylaxis of COVID-19 infection. The reporter stated the COVID-19 vaccine was stored at -20 degrees Fahrenheit; outside of the recommended temperature range. No treatment information was provided. Action taken with mRNA-1273 in response to the event was not reported. The event, vaccine that was stored at -20 degrees F so outside of the temperature range, was considered resolved.; Reporter's Comments: This case concerns a patient who received their first of two planned doses of mRNA-1273 (Lot unknown), reporting Product storage error without any associated adverse events.

Other Meds:

Current Illness:

ID: 0945896
Sex: U
Age:
State: NM

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

Lab Data:

Allergies:

Symptoms: Vaccine was stored at -20 Degrees F so outside of the Temperature range; A spontaneous report was received from a pharmacist concerning a patient who received Moderna's COVID-19 vaccine (mRNA-1273) that was stored at -20 degrees F, so outside of the temperature range. The patient's medical history was not provided. No relevant concomitant medications were reported. On an unknown date, the patient received their first of two planned doses of mRNA-1273 intramuscularly for prophylaxis of COVID-19 infection. The reporter stated the COVID-19 vaccine was stored at -20 degrees Fahrenheit; outside of the recommended temperature range. No treatment information was provided. Action taken with mRNA-1273 in response to the event was not reported. The event, vaccine that was stored at -20 degrees F so outside of the temperature range, was considered resolved.; Reporter's Comments: This case concerns a patient who received their first of two planned doses of mRNA-1273 (Lot unknown), reporting Product storage error without any associated adverse events.

Other Meds:

Current Illness:

ID: 0945897
Sex: F
Age: 37
State: CA

Vax Date: 12/23/2020
Onset Date: 12/23/2020
Rec V Date: 01/15/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Did not receive a full dose; A spontaneous report was received from a nurse concerning a 37-year-old, female patient who received Moderna's COVID-19 Vaccine (mRNA-1273) and did not receive the full dose. The patient's medical history was not provided. Concomitant product use was not provided/unknown by the reporter. On 23 Dec 2020, the patient received their first of two planned doses of mRNA-1273 (Lot number 025J202A) intramuscularly in the left arm for prophylaxis of COVID-19 infection. The nurse reported that a possible administration error may have occurred because she did not screw on the hub properly. The patient did not receive a full dose. Treatment information was not provided. Action taken with mRNA-1273 in response to the events was not provided/unknown. The event, patient did not receive the full dose, was considered resolved on 23 Dec 2020.; Reporter's Comments: This case concerns a 37-year-old female patient who received their first of two planned doses of mRNA-1273 (Lot 025J202A), reporting did not receive a full dose without any associated adverse events.

Other Meds:

Current Illness:

ID: 0945898
Sex: U
Age:
State: NY

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

Lab Data:

Allergies:

Symptoms: Person who first dose of Moderna vaccine...was a 17 year old; A spontaneous report was received from a pharmacist concerning a 17-year-old consumer who received Moderna's COVID-19 vaccine and was at an inappropriate age at vaccine administration. The patient's medical history was not provided. No relevant concomitant medications were reported. On 01 Jan 2021 prior to the onset of the events, the patient received their first of two planned doses of mRNA-1273 for prophylaxis of COVID-19 infection. On 01 JAN 2021, a 17-year-old patient was given the vaccine and is outside the lower age limit for Moderna's mRNA-1273 vaccine. No adverse events were reported. No treatment information was provided. Action taken with the second dose of mRNA-1273 in response to the event was not reported. The event, inappropriate age at vaccine administration, was considered resolved on 01 Jan 2021.; Reporter's Comments: This case concerns a 17 year old patient. The patient's medical history is not provided. The event occurred on 01 Jan 2021 during administration of the first dose of the mRNA-1273. This report refers to a case of medication error where mRNA-1273 has been administered to the patient of inappropriate age. There were no reported adverse reaction associated with this case.

Other Meds:

Current Illness:

ID: 0945899
Sex: F
Age: 65
State: TX

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

Lab Data:

Allergies:

Symptoms: Loss of range of motion; Can't sleep; Pain at the injection site; Vaccine was given in the left deltoid bursa instead of the deltoid muscle; A spontaneous report was received from a 65 year-old, female physician, who is also the patient, who received Moderna's COVID-19 vaccine and experienced vaccine was given in the left deltoid bursa instead of the deltoid muscle, loss of range of motion, can't sleep, and pain at the injection site. The patient's medical history was not provided. Concomitant product use was not provided by the reporter. On 02 Jan 2021, the patient received their first of two planned doses of mRNA-1273 (Lot number: 011L20A) intramurally in the left deltoid bursa for prophylaxis of COVID-19 infection. On 02 Jan 2021, the patient reported she had been given the vaccine in the wrong location. The vaccine was given in the left deltoid bursa instead of the deltoid muscle. The patient was also experiencing loss of range of motion, pain at the injection site, and she also can't sleep. Treatment information was not provided. Action taken with mRNA-1273 in response to the events was unknown. The event vaccine was given in the left deltoid bursa instead of the deltoid muscle was considered resolved on 02 Jan 2021. The events loss of range of motion, can't sleep, and pain at the injection site were considered not recovered/not resolved.; Reporter's Comments: This report refers to a case of 65 year old female patient who experienced non-serious unexpected events of vaccine was given in the left deltoid bursa instead of the deltoid muscle for mRNA-1273, lot # 011L20A. The patient experienced loss of range of motion, pain at the injection site, and can't sleep. Onset latency was not provided. De-challenge and re-challenge are not applicable. Based on the information provided the events of vaccine was given in the left deltoid bursa instead of the deltoid muscle, loss of range of motion and can't sleep are assessed as unlikely related to mRNA-1273 as this is due to product administration error. The event of pain at the injection site is included in the known safety profile of the vaccine, hence a causal association cannot be excluded.

Other Meds:

Current Illness:

ID: 0945900
Sex: F
Age:
State:

Vax Date: 12/31/2020
Onset Date: 12/31/2020
Rec V Date: 01/15/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Anaphylactic shock; A spontaneous report was received from a female consumer who received Moderna's COVID-19 Vaccine and experienced anaphylactic shock. The patient's medical history was not provided. No concomitant product use was reported. On 31 Dec 2020, prior to the onset of the events, the patient received their first of two planned doses of mRNA-1273 intramuscularly for prophylaxis of COVID-19 infection. On 31 Dec 2020, after vaccine administration, the patient experienced anaphylactic shock and was taken to the hospital. No treatment information was provided. On 01 Jan 2021, the patient reported feeling much better. Action taken with mRNA-1273 in response to the event was not reported. The event, anayphylactic shock, was considered resolved on 01 Jan 2021.; Reporter's Comments: This case concerns a female patient with unknown medical history, who received their first of two planned doses of mRNA-1273 (Lot unknown), and who experienced the serious unlisted event of anaphylactic shock. Very limited information regarding this event has been provided at this time. Based on temporal association between the use of the product and the onset of the event on the day of vaccination, a causal relationship cannot be excluded and the event was considered possibly related to the vaccine.

Other Meds:

Current Illness:

ID: 0945901
Sex: F
Age:
State: NY

Vax Date: 12/31/2020
Onset Date: 12/31/2020
Rec V Date: 01/15/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Needle fell off of the cartridge; Couple of drops of vaccine fell onto elbow; A spontaneous report was received from a healthcare professional, who was also a female patient, who received Moderna's COVID-19 Vaccine, and experienced needle fell off the cartridge, and couple drops of vaccine fell onto her elbow. The patient's medical history was not provided. No relevant concomitant medications were reported. On 31 Dec 2020, 0 hours prior to the onset of the events, the patient received their first of two planned doses of mRNA-1273 intramuscularly for prophylaxis of COVID-19 infection. On 31 Dec 2020, during vaccine administration, the patient reported the needle fell off the cartridge when the nurse was injecting the vaccine, and a couple drops of vaccine fell onto her elbow. No treatment information was provided. Action taken with mRNA-1273 in response to the events was not reported. The events, needle fell off the cartridge, and couple drops of vaccine fell onto her elbow, were considered resolved on 31 Dec 2020.; Reporter's Comments: This case concerns a female patient of an unknown age. The patient's medical history and concomitant medications were not provided. The patient experienced a non serious event of needle fell off the cartridge, and couple of drops of vaccine fell onto her elbow. The event occurred on the same day as the first dose of the mRNA-1273. Very limited information regarding this event has been provided at this time. Additional information is required for further assessment.

Other Meds:

Current Illness:

ID: 0945902
Sex: F
Age:
State:

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

Lab Data:

Allergies:

Symptoms: Vaccine given to 16 year old; A spontaneous report was received from a pharmacist concerning a 16-year-old female patient who received Moderna's COVID-19 vaccine (mRNA-1273) resulting in the event, vaccine given to a 16 year old. The patient's medical history was not provided. No relevant concomitant medications were reported. On 1 Jan 2021, the patient received their first of two planned doses of mRNA-1273 (Lot number: 025J20A) intramuscularly for prophylaxis of COVID-19 infection. On 1 Jan 2021, vaccine was given to a 16-year-old, per the pharmacist. The patient had no reported adverse reactions. No treatment information was provided. Action taken with mRNA-1273 in response to the event was not reported. The outcome of the event, vaccine given to 16 year old, was considered resolved on 1 Jan 2021.; Reporter's Comments: This report refers to a case of product administered to patient of inappropriate age for mRNA-1273. There were no reported adverse events associated with this case.

Other Meds:

Current Illness:

ID: 0945903
Sex: F
Age: 53
State: IN

Vax Date: 01/02/2020
Onset Date: 01/02/2021
Rec V Date: 01/15/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Some of the dose squirted out on her; A spontaneous report was received from a health care professional, concerning a 54-year old, female patient who received Moderna's COVID-19 vaccine (mRNA-1273) and experienced incomplete dose administered. The patient's medical history was not provided. No relevant concomitant medications were reported. On 02 Jan 2021, the patient received their first of two planned doses of mRNA-1273 (Lot number unknown) intramuscularly, in right arm, for prophylaxis of COVID-19 infection. On 02 Jan 2021, the patient stated that some of the dose squirted out on her. No treatment information was reported. Action taken with mRNA-1273 in response to the event was not reported. The event, incomplete dose administered, was considered resolved on 02 Jan 2021.; Reporter's Comments: This report refers to a case of incorrect dose administered for mRNA-1273, lot # unknown. There were no reported AEs associated with this case of incorrect dose administered.

Other Meds:

Current Illness:

ID: 0945904
Sex: F
Age:
State: NY

Vax Date: 12/24/2020
Onset Date: 12/24/2020
Rec V Date: 01/15/2021
Hospital:

Lab Data:

Allergies:

Symptoms: 16 year old was inadvertently given the Moderna COVID 19 vaccine; A spontaneous report (United States) was received from a pharmacist concerning a 16-year-old female patient who received Moderna's COVID-19 vaccine (mRNA-1273) resulting in the event, 16 year old received vaccine. The patient's medical history was not provided. Concomitant medications were not reported. On 24 Dec 2020, the patient received their first of two planned doses of mRNA-1273 (Lot number 025J20A) intramuscularly for prophylaxis of COVID-19 infection. The reporter stated that the Moderna COVID-19 vaccine was inadvertently given to the patient by one of their staff with the consent of the parent. No treatment information was provided. Action taken with mRNA-1273 in response to the event was unknown. The event, 16 year old received vaccine, was considered resolved on 24 Dec 2020.; Reporter's Comments: This report refers to a case of product administered to patient of inappropriate age for mRNA-1273, lot # 025J20A. There were no reported AEs associated with this case of product administered to patient of inappropriate age.

Other Meds:

Current Illness:

ID: 0945905
Sex: F
Age: 29
State: MT

Vax Date: 12/31/2020
Onset Date: 01/01/2021
Rec V Date: 01/15/2021
Hospital:

Lab Data: Test Date: 20210103; Test Name: Monocyte count; Result Unstructured Data: Per the patient

Allergies:

Symptoms: Achy neck; Stiff neck; Monocyte was high; Diarrhea; Passed out; Very dizzy; Chills; Headache; Fatigue; Walking across a room takes breath out; Lightheaded; A spontaneous report was received from a consumer, who was a 29-year-old female patient who received Moderna's COVID-19 Vaccine (mRNA-1273) and experienced the events, passed out, very dizzy, lightheaded, fatigue, walking across a room takes breath out, headache, chills, diarrhea, monocyte was high, and stiff and achy neck. The patient's medical history was not provided. Concomitant product use included acetylsalicylic acid. On 31 Dec 2020, approximately one day prior to the onset of the symptoms, the patient received their first of two planned doses of mRNA-1273 intramuscularly in the right arm for prophylaxis of COVID-19 infection. During the morning hours of 01 Jan 2021, the patient passed out, felt dizzy, lightheaded, fatigued, had a headache, and chills. The patient reported that walking across a room took the breath out of her. On 02 Jan 2021 the patient experienced diarrhea in the evening. On 03 Jan 2021 the patient presented to the emergency room but was not admitted. Her monocyte count was high, but other lab results were normal. Her headache was treated with anti-migraine medication intravenously. She stated she was still experiencing dizziness and her neck was still achy and stiff. No additional treatment information was provided. Action taken with mRNA-1273 in response to the events was not provided. The outcome of the events, passed out, lightheaded, fatigue, walking across a room takes breath out, headache, chills, diarrhea, and monocyte was high, was unknown. The events, dizziness and stiff and achy neck, were considered not resolved.; Reporter's Comments: This case concerns a 29-year-old female patient with unknown medical history, who received their first of two planned doses of mRNA-1273 (Lot 0371C20A), and who experienced the serious unlisted event of Syncope, the non-serious listed events of diarrhea, chills, headache, and fatigue, and the non-serious unlisted events of Dizziness, Monocyte count increased, Musculoskeletal stiffness, Dizziness (lightheadedness), Neck pain, and Dyspnoea. Based on the current available information and temporal association between the use of the product and the onset of the events on the day after vaccination, a causal relationship cannot be excluded and the events are considered possibly related to the vaccine. The events may be explained by an undiagnosed viral illness based on the constellation of symptoms and elevated monocyte count.

Other Meds: BABY ASPIRIN

Current Illness:

ID: 0945906
Sex: F
Age:
State: MD

Vax Date: 01/06/2021
Onset Date: 01/06/2021
Rec V Date: 01/15/2021
Hospital:

Lab Data: Test Date: 20201218; Test Name: COVID Antibody Test; Test Result: Negative ; Test Date: 20200826; Test Name: Nasal Swab/ Covid test; Test Result: Negative ; Test Date: 20201218; Test Name: Nasal Swab/ Covid test; Test Result: Negative

Allergies:

Symptoms: Muscle pain, joint pain, body ache, headache, head pressure, and intermittent dizziness/vertigo; Muscle pain, joint pain, body ache, headache, head pressure, and intermittent dizziness/vertigo; Muscle pain, joint pain, body ache, headache, head pressure, and intermittent dizziness/vertigo; Muscle pain, joint pain, body ache, headache, head pressure, and intermittent dizziness/vertigo; Muscle pain, joint pain, body ache, headache, head pressure, and intermittent dizziness/vertigo; Muscle pain, joint pain, body ache, headache, head pressure, and intermittent dizziness/vertigo; Muscle pain, joint pain, body ache, headache, head pressure, and intermittent dizziness/vertigo; This is a spontaneous report from other health professional. A 34-year-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), lot number: EJ1686, via an unspecified route of administration from 06Jan2021 11:00 at a single dose for covid-19 immunization. Medical history included Sulfa sensitivity (but allergy not confirmed). Historical vaccine included BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE) lot number: EH9899, from 18Dec2020 for covid-19 immunization (1st dose). Concomitant medication included lisdexamfetamine mesilate (VYVANSE) and drospirenone, ethinylestradiol (OCELLA), drospirenone, ethinylestradiol (YASMIN). On 06Jan2021 12:00, the patient experienced muscle pain, joint pain, body ache, headache, head pressure, and intermittent dizziness/vertigo. The patient underwent lab tests and procedures on 26Aug2020 which included Nasal Swab/ Covid test with negative result; then on 18Dec2020, COVID Antibody Test and COVID Antibody Test both with negative results. The outcome of event was not recovered. No treatment was received/required due to the events. No follow-up attempts possible. No further information expected. Information on the batch number has been obtained.

Other Meds: VYVANSE; OCELLA; YASMIN

Current Illness:

ID: 0945907
Sex: F
Age:
State: NY

Vax Date: 01/07/2021
Onset Date: 01/08/2021
Rec V Date: 01/15/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Tiredness; headache; muscle pain; fever; feeling unwell; nausea; joints pain; injection site swelling/redness; injection site swelling/redness; This is a spontaneous report from a contactable nurse. A 37-year-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE),Batch/lot number: EK9231, intramuscular in the right arm, from 07Jan2021 07:45 at a single dose for covid-19 immunization. The patient's medical history and concomitant medications were not reported. Prior to vaccination, the patient was not diagnosed with COVID-19. Since the vaccination, the patient has not been tested for COVID-19. On 08Jan2021 02:30, the patient experienced tiredness, headache, muscle pain, fever, feeling unwell, nausea, joints pain and injection site swelling/redness. The outcome of events was not recovered. No follow-up attempts possible. No further information expected. Information on the batch number has been obtained.

Other Meds:

Current Illness:

ID: 0945908
Sex: F
Age:
State:

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

Lab Data:

Allergies:

Symptoms: Very tiny bit of a headache; This is a spontaneous report from a contactable consumer (patient). A female patient of an unspecified age started received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE; lot number and expiry date not reported), via an unspecified route of administration on an unspecified date at single dose for COVID-19 immunization, alprazolam (XANAX), via an unspecified route of administration from an unspecified date to an unspecified date at an unspecified dosage regimen for an unspecified indication. Medical history included headache from an unknown date and unknown if ongoing (known to have headaches since her husband passed away in May2020). The patient's concomitant medications were not reported. The patient received the vaccine 2 hours (as reported) and experienced very tiny bit of a headache on an unspecified date. The action taken in response to the event for alprazolam was unknown. The patient inquired if they can take ibuprofen. The outcome of the event was unknown. Information about lot/batch number has been requested.

Other Meds:

Current Illness:

ID: 0945909
Sex: F
Age:
State: CO

Vax Date: 01/05/2021
Onset Date: 01/05/2021
Rec V Date: 01/15/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Left sided facial neuropathy, cheek, nose, ear and tingling lips; Left sided facial neuropathy, cheek, nose, ear and tingling lips; This is a spontaneous report from a contactable Other HCP. A 62-years-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 MRNA VACCINE), lot EL3246, intramuscularly on 05Jan2021 16:00 at single dose for covid-19 immunisation. Medical history included arthritis (degenerative arthritis). There were no concomitant medications. Anatomical Location: Arm Left Facility location: Hospital. The patient did not eceived any other vaccines within 4 weeks prior to the COVID vaccine. The patient experienced left sided facial neuropathy, cheek, nose, ear and tingling lips on 05Jan2021 16:45 with outcome of not recovered. The action taken was not applicable. No treatment received; Sender's Comments: Based on the information available, a possible contributory role of the suspect products cannot be excluded for the reported events due to temporal association. The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to Regulatory Authorities, Ethics Committees and Investigators as appropriate.

Other Meds:

Current Illness:

ID: 0945910
Sex: M
Age:
State: WA

Vax Date: 12/19/2020
Onset Date: 12/19/2020
Rec V Date: 01/15/2021
Hospital:

Lab Data:

Allergies:

Symptoms: felt a little bit dizzy; lightheaded; a little clammy; had tingling in the legs; general malaise; This is a spontaneous report from a contactable physician, the patient. A male patient of an unspecified age received the first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 MRNA VACCINE), Lot number: EK5730 & Expiry: 31Mar2021, via an unspecified route of administration on 19Dec2020 (at an unspecified age) as a single dose for COVID-19 immunization. Medical history included severe allergic reaction to a plant, reported as 23 years ago, and he has not had any other type of allergic reaction and hasn't had any reactions to any vaccine. Concomitant medications were not reported. On 19Dec2020, reported as within 10 minutes of receiving the vaccine, the patient felt a little bit dizzy, lightheaded, a little clammy, and had tingling in the legs, all of which went away quickly afterwards, within 5 minutes. The patient also had the typical side effects after receiving the vaccine such as general malaise for 24 hours. He had felt fine ever since then. The patient was supposed to receive his second dose "tonight or tomorrow morning" and queried whether there was any guidance on pre-medicating with diphenhydramine (BENADRYL). The clinical outcome of the events felt a little bit dizzy, lightheaded, a little clammy, had tingling in the legs, and general malaise were resolved on Dec2020.

Other Meds:

Current Illness:

ID: 0945911
Sex: F
Age:
State: TX

Vax Date: 12/24/2020
Onset Date: 01/05/2021
Rec V Date: 01/15/2021
Hospital:

Lab Data: Test Date: 20210104; Test Name: Nasal Swab; Result Unstructured Data: Test Result:Positive

Allergies:

Symptoms: Had COVID infection 10 days after the getting the vaccine; Had COVID infection 10 days after the getting the vaccine; This is a spontaneous report from a contactable physician. A 48-year-old female patient received the first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE; lot number: EK5730), intramuscular in right arm on 24Dec2020 09:00 at a single dose for Covid-19 immunization. Medical history was reported as none. The patient's concomitant medications were not reported. The patient was not pregnant at the time of vaccination. Patient did not receive any other vaccines within 4 weeks prior to Covid vaccine. The patient was not diagnosed with Covid-19 prior to vaccination. Patient has no allergies to medications, food, or other products. Physician would like to know if her patient can receive second dose of vaccine. Patient received vaccine 10 days ago. On 05Jan2021, the patient had Covid infection 10 days after the getting the vaccine. No treatment was received for the event. Patient tested positive for Covid after receiving vaccine. The patient underwent lab test which included nasal swab: positive on 04Jan2021. The outcome of the event was recovering.; Sender's Comments: Based on the information available, a possible contributory role of the suspect BNT162B2 cannot be excluded for the reported COVID 19 infection based on the known safety profile. However the short duration of 10 days since the vaccine first dose is given it is unlikely patient would have fully developed immunity.

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 134,999

Page last modified: 14 December 2021 10:42pm