VAERS 2021 Database www.vaers.hhs.gov

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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: 1315860
Sex: F
Age: 57
State: VA

Vax Date: 04/21/2021
Onset Date: 04/24/2021
Rec V Date: 05/13/2021
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: None

Symptom List: Dysphagia, Epiglottitis

Symptoms: Pt developed muscle pain about 3-4 days after vaccination. She didn't feel pain initially but started feeling pain and pain still persists after 3 weeks. She cannot move her arm. The location is not where she got vaccinated but below. There is no lump or redness. Pt still wanted to get 2nd dose and got vaccinated on right deltoid on 5/12/21.

Other Meds: n/a

Current Illness:

ID: 1315861
Sex: F
Age: 34
State: PA

Vax Date: 05/11/2021
Onset Date: 05/13/2021
Rec V Date: 05/13/2021
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: No

Symptom List: Anxiety, Dyspnoea

Symptoms: I received my 2nd vaccine and My period came 5 days early and I am bleeding heavy and clotting quarter size clots. Started about 8:30pm on 5/13/2021.

Other Meds: None

Current Illness: No

ID: 1315862
Sex: F
Age: 28
State: CA

Vax Date: 04/29/2021
Onset Date: 04/29/2021
Rec V Date: 05/13/2021
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: Cats, latex, pollen

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

Symptoms: Felt initial burning in back of respective hand, pressure in face, particularly in eyes in first 15 minutes. During 15 minute drive home, began to feel progressively 'off'. Ultimately developed skin reaction that was burning/itchy and respiratory response which required inhaler. Felt terrible until 10 PM. Hivey skin reaction continued into next day. Standard sore arm and occasionally skin reaction sporadically come and go in the last 2 weeks.

Other Meds: Spironolactone, gianvi generic birth control

Current Illness:

ID: 1315863
Sex: F
Age: 66
State: LA

Vax Date: 05/04/2021
Onset Date: 05/04/2021
Rec V Date: 05/13/2021
Hospital:

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

Lab Data:

Allergies: unknown

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: temperature excursion with vaccine administration

Other Meds: unknown

Current Illness: unknown

ID: 1315864
Sex: F
Age: 35
State: MI

Vax Date: 04/15/2021
Onset Date: 04/23/2021
Rec V Date: 05/13/2021
Hospital:

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

Lab Data:

Allergies: Avalon Clindamycin Augmentin Bactrim

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

Symptoms: I woke up on April 23 (8 days after my vaccine) with a rash on my upper, inner legs. It was slightly raised and red in color. On the 24th I woke up to a little bit more of the rash. It spread to the front of my left leg. I also had a few spots on both hands on palms and on the back of my hands. I had very few spots on my feet, but my feet were extremely itchy. Woke up on the 25th and nothing seemed to have changed. On the 26th as the day went on the spots got lighter. This continued another day or 2 until the rash was completely gone. I was never seen by a professional.

Other Meds: Vitamin D3 and a multivitamin

Current Illness: Sore throat that would come and go

ID: 1315865
Sex: M
Age: 54
State: NJ

Vax Date: 04/08/2021
Onset Date: 04/12/2021
Rec V Date: 05/13/2021
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: pennicillin, iodine contrast

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

Symptoms: high pitched tinitus in both ears.

Other Meds: Pepcid AD, urocit K, allopurinol, vitamin D3, Probiiotic

Current Illness:

ID: 1315866
Sex: F
Age: 24
State: NJ

Vax Date: 03/01/2021
Onset Date: 04/11/2021
Rec V Date: 05/13/2021
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: NA

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Major fatigue, light headed/dizziness, missed period , extreme nausea and fatigue

Other Meds: Lamictal, effexor

Current Illness: NA

ID: 1315867
Sex: M
Age: 22
State: IN

Vax Date: 05/11/2021
Onset Date: 05/11/2021
Rec V Date: 05/13/2021
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: Nausea, muscle pain throughout body for the first 12 hours Unusually delirious dreams Vomiting second night After vomiting and normal sleep, rapid recovery

Other Meds: None

Current Illness: None

ID: 1315868
Sex: M
Age: 62
State: KY

Vax Date: 03/17/2021
Onset Date: 03/27/2021
Rec V Date: 05/13/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Bell's palsy (a neurological condition where drooping of the eye lid and the face happens); This spontaneous case was reported by a physician assistant (subsequently medically confirmed) and describes the occurrence of BELL'S PALSY (Bell's palsy (a neurological condition where drooping of the eye lid and the face happens)) in a 62-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. Concomitant products included LISINOPRIL, LOVASTATIN, QUETIAPINE FUMARATE (SEROQUEL) and TRAZODONE for an unknown indication. On 17-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 27-Mar-2021, the patient experienced BELL'S PALSY (Bell's palsy (a neurological condition where drooping of the eye lid and the face happens)) (seriousness criterion medically significant). At the time of the report, BELL'S PALSY (Bell's palsy (a neurological condition where drooping of the eye lid and the face happens)) outcome was unknown. mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was withdrawn on an unknown date. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No adverse event as Medical History was reported. Patient did not receive the second dose of the vaccine due to this condition. Treatment information not provided. 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.; Sender's Comments: 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: LISINOPRIL; LOVASTATIN; SEROQUEL; TRAZODONE

Current Illness:

ID: 1315869
Sex: M
Age: 31
State: CA

Vax Date: 05/12/2021
Onset Date: 05/12/2021
Rec V Date: 05/13/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Diarrhoea, Nasal congestion

Symptoms: PATIENT RECEIVED COVID VACCINE MIXED WITH BACTERIOSTATIC 0.9% NORMAL SALINE INSTEAD OF PLAIN NORMAL SALINE 0.9%

Other Meds:

Current Illness:

ID: 1315870
Sex: F
Age: 33
State: GA

Vax Date: 04/09/2021
Onset Date: 04/22/2021
Rec V Date: 05/13/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Bleeding in-between periods. Not a lot, but enough and unusual.

Other Meds: Vyvanse, Spironolactone

Current Illness:

ID: 1315871
Sex: M
Age: 34
State: CA

Vax Date: 05/11/2021
Onset Date: 05/11/2021
Rec V Date: 05/13/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 039k20a
Dose Series: 1
Vax Route: SYR
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Rash, Urticaria

Symptoms: PATIENT RECEIVED COVID VACCINE MIXED WITH BACTERIOSTATIC 0.9% NORMAL SALINE INSTEAD OF PLAIN NORMAL SALINE 0.9%. THIS WAS DISCOVERED ON 5.12.21

Other Meds:

Current Illness:

ID: 1315872
Sex: F
Age: 30
State: CA

Vax Date: 04/15/2021
Onset Date: 05/20/2021
Rec V Date: 05/13/2021
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: Blood pressure decreased, Chest pain, Chills, Confusional state, Decreased appetite

Symptoms: ?Covid? arm: big rash on left arm at injection site. Lasted 3-4 days. Didn?t hurt but was itchy and hot for a couple if days.

Other Meds: Advil

Current Illness: No

ID: 1315873
Sex: F
Age: 42
State: MO

Vax Date: 03/27/2021
Onset Date: 03/28/2021
Rec V Date: 05/13/2021
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: Poison Ivy and Oak

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

Symptoms: Fever, muscle aches, fatigue lasting 24 hours.

Other Meds: Zyrtec

Current Illness: None

ID: 1315874
Sex: F
Age: 22
State: MN

Vax Date: 04/27/2021
Onset Date: 04/28/2021
Rec V Date: 05/13/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: Gastritis with potential peptic ulcers. Began with severe heartburn and stomach pain the day after vaccination. Went to two emergency rooms, a visit with primary care provider, underwent blood testing (inconclusive), H. Pylori breath testing (negative), and am scheduled for an upper endoscopy, HIDA scan, and GI visit.

Other Meds: Zyrtec, Zoloft

Current Illness:

ID: 1315875
Sex: F
Age: 18
State: TX

Vax Date: 05/13/2021
Onset Date: 05/13/2021
Rec V Date: 05/13/2021
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: nka

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

Symptoms: Patient passed out while on her 15 minutes of observation after the vaccine , she woke up quickly and threw up ,she was conscious , her dad was with her all the time, we offered her the first aids , she was feeling well after approximately 20 minutes.

Other Meds: n/a

Current Illness: n/a

ID: 1315876
Sex: M
Age: 41
State: IN

Vax Date: 04/05/2021
Onset Date: 05/04/2021
Rec V Date: 05/13/2021
Hospital:

Vax Type: DTAPHEPBIP
Manufacturer: GLAXOSMITHKLINE BIOLOGICALS
Vax Name: DTAP + HEPB + IPV (PEDIARIX)
Lot:
Dose Series: UNK
Vax Route:
Vax Site: LG

Lab Data:

Allergies:

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

Symptoms: doesn't remember anything; muscle spasms in back and legs; very tired; very sore; fever; grand mal seizures; sweating and being soak and wet; This spontaneous case was reported by a patient (subsequently medically confirmed) and describes the occurrence of GENERALISED TONIC-CLONIC SEIZURE (grand mal seizures) in a 42-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 037B21A and 006B21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. Concurrent medical conditions included Epilepsy (The patient has a history of grand mal, petit mal and stress seizures. Patient stated that he has at least one minor seizure once a month and the last seizure he had with this great intensity was about 3 to 4 months ago.) and Drug allergy (aspirin). Concomitant products included MIDAZOLAM for Seizure, CLOBAZAM (ONFI), ESLICARBAZEPINE ACETATE (APTIOM) and TOPIRAMATE (TOPAMAX) for an unknown indication. On 05-Apr-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 04-May-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 04-May-2021, the patient experienced GENERALISED TONIC-CLONIC SEIZURE (grand mal seizures) (seriousness criterion medically significant). 04-May-2021, the patient experienced HYPERHIDROSIS (sweating and being soak and wet) and PYREXIA (fever). On 05-May-2021, the patient experienced MEMORY IMPAIRMENT (doesn't remember anything), MUSCLE SPASMS (muscle spasms in back and legs), FATIGUE (very tired) and MYALGIA (very sore). On 05-May-2021, GENERALISED TONIC-CLONIC SEIZURE (grand mal seizures) had resolved. At the time of the report, HYPERHIDROSIS (sweating and being soak and wet), MEMORY IMPAIRMENT (doesn't remember anything), MUSCLE SPASMS (muscle spasms in back and legs), FATIGUE (very tired), MYALGIA (very sore) and PYREXIA (fever) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 05-May-2021, Blood test: unknown (Inconclusive) Result not provided. It was reported that the patient took midazolam and swiped his magnet across his vagus nerve stimulator (VNS) for treatment. Action taken with mRNA-1273 in response to the event was Not Applicable It was reported that the patient was asymptomatic after first dose and experienced symptoms on 04May2021 at midnight after second dose of vaccine. 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. The medical history of epilepsy was assessed as strong cofounder.; Sender'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. The medical history of epilepsy was assessed as strong cofounder.

Other Meds: ONFI; APTIOM; TOPAMAX; MIDAZOLAM

Current Illness: Drug allergy (aspirin); Epilepsy (The patient has a history of grand mal, petit mal and stress seizures. Patient stated that he has at least one minor seizure once a month and the last seizure he had with this great intensity was about 3 to 4 months ago.)

ID: 1315877
Sex: U
Age:
State: CO

Vax Date: 04/29/2021
Onset Date:
Rec V Date: 05/13/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Ear pain, Hypoaesthesia

Symptoms: 2 episodes of pass out whom got the second dose; 3 patients felt unwell whom got the first dose; Based on the current case data, this case has been classified as invalid. This spontaneous case was reported by a nurse and describes the occurrence of LOSS OF CONSCIOUSNESS (2 episodes of pass out whom got the second dose) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 008C21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 29-Apr-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On an unknown date, the patient experienced LOSS OF CONSCIOUSNESS (2 episodes of pass out whom got the second dose) (seriousness criterion medically significant) and MALAISE (3 patients felt unwell whom got the first dose). At the time of the report, LOSS OF CONSCIOUSNESS (2 episodes of pass out whom got the last dose) and MALAISE (3 patients felt unwell whom got the first dose) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. Very limited information regarding these events has been provided at this time. Further information has been requested. Most recent FOLLOW-UP information incorporated above includes: On 29-Apr-2021: Additional event of malaise reported, 5 total cases reported, event dates provided On 30-Apr-2021: No new information; Sender's Comments: Very limited information regarding these events has been provided at this time. Further information has been requested.

Other Meds:

Current Illness:

ID: 1315878
Sex: U
Age:
State: CO

Vax Date: 04/29/2021
Onset Date: 04/29/2021
Rec V Date: 05/13/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: 2 episodes of pass out whom got the second dose; 3 patients felt unwell whom got the first dose; Based on the current case data, this case has been classified as invalid. This spontaneous case was reported by an other health care professional and describes the occurrence of LOSS OF CONSCIOUSNESS (2 episodes of pass out whom got the second dose) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 008C21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 29-Apr-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 29-Apr-2021, the patient experienced LOSS OF CONSCIOUSNESS (2 episodes of pass out whom got the second dose) (seriousness criterion medically significant) and MALAISE (3 patients felt unwell whom got the first dose). At the time of the report, LOSS OF CONSCIOUSNESS (2 episodes of pass out whom got the last dose) and MALAISE (3 patients felt unwell whom got the first dose) outcome was unknown. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. Treatment was unknown. This case concerns an adult patient of unknown age and gender with a serious unexpected event of loss of consciousness, and nonserious unexpected malaise. Latency within 1 day after first dose mRNA-1273. 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. Reporter did not allow further contact Most recent FOLLOW-UP information incorporated above includes: On 29-Apr-2021: Significant: No of patients and events given

Other Meds:

Current Illness:

ID: 1315879
Sex: F
Age: 66
State: VA

Vax Date: 03/09/2021
Onset Date: 04/27/2021
Rec V Date: 05/13/2021
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: Bell's Palsy; Numbness in her gums in her mouth; Missed 2nd dose; This spontaneous case was reported by a consumer and describes the occurrence of BELL'S PALSY (Bell's Palsy) in a 66-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 09-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 27-Apr-2021, the patient experienced BELL'S PALSY (Bell's Palsy) (seriousness criterion medically significant), HYPOAESTHESIA ORAL (Numbness in her gums in her mouth) and INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (Missed 2nd dose). At the time of the report, BELL'S PALSY (Bell's Palsy) and HYPOAESTHESIA ORAL (Numbness in her gums in her mouth) had not resolved and INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (Missed 2nd dose) had resolved. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. The patient was on several unknown medications daily. Treatment includes 60mg Prednisone for 7 days and many unknown medication for treatment Company Comment Based on the current available information and temporal association between the use of the product and the start date of the events( Bell's palsy and hypoaesthesia oral) , a causal relationship cannot be excluded. This report also refers to a case of inappropriate schedule of product administration for mRNA-1273

Other Meds:

Current Illness:

ID: 1315880
Sex: M
Age: 61
State: MA

Vax Date: 05/01/2021
Onset Date: 05/02/2021
Rec V Date: 05/13/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: Eh9899
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: This spontaneous case was reported by a consumer and describes the occurrence of CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD), ASTHMA (Asthma) and DYSPNOEA (Difficulty breathing which started in the morning and got worst by evening / Barely catch his breath) in a 61-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 013M20A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. The patient's past medical history included Heavy smoker in 2020. On 01-May-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 02-May-2021, the patient experienced INFLUENZA LIKE ILLNESS (Flu-like symptoms), CHILLS (Chills), PYREXIA (Fever) and HEADACHE (Headache). On 03-May-2021, the patient experienced PRURITUS (Feeling scratchy). On 04-May-2021, the patient experienced CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD) (seriousness criterion medically significant), ASTHMA (Asthma) (seriousness criterion medically significant), DYSPNOEA (Difficulty breathing which started in the morning and got worst by evening / Barely catch his breath) (seriousness criterion medically significant) and WHEEZING (Wheezing sounds). On 02-May-2021, INFLUENZA LIKE ILLNESS (Flu-like symptoms), CHILLS (Chills), PYREXIA (Fever) and HEADACHE (Headache) had resolved. On 03-May-2021, PRURITUS (Feeling scratchy) had resolved. On 06-May-2021, CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD), ASTHMA (Asthma), DYSPNOEA (Difficulty breathing which started in the morning and got worst by evening / Barely catch his breath) and WHEEZING (Wheezing sounds) had resolved. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 04-May-2021, Oxygen saturation: 91 Low. On 03-May-2021, the patient was feeling scratchy and mentioned it could be due to pollen. On 04-May-2021, he was experiencing difficulty breathing, which began in the morning and exacerbated by the evening. He had wheezing sound and by 6 PM he could barely catch his breath. He got breathing treatment using nebulizer and his oxygen level was 91. By 8 PM he went to the ER and underwent tests. He was diagnosed to have Asthma and COPD. Treatment: Inhaler, nebulizer and steroid. Company Comment: 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.; Sender'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: 1315881
Sex: F
Age:
State:

Vax Date: 01/01/2021
Onset Date:
Rec V Date: 05/13/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Unevaluable event

Symptoms: This spontaneous case was reported by a consumer and describes the occurrence of PLASMA CELL MYELOMA (multiple myeloma experience accelerated lesions) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. In January 2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. In February 2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On an unknown date, the patient experienced PLASMA CELL MYELOMA (multiple myeloma experience accelerated lesions) (seriousness criterion medically significant). At the time of the report, PLASMA CELL MYELOMA (multiple myeloma experience accelerated lesions) outcome was unknown. Very limited information regarding this event/s has been provided at this time. Further information has been requested.; Sender's Comments: Very limited information regarding this event/s has been provided at this time. Further information has been requested.

Other Meds:

Current Illness:

ID: 1315882
Sex: M
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 05/13/2021
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:

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

Symptoms: Severe diarrhoea; Weight loss 80 lbs; Nausea; This spontaneous case was reported by a patient family member or friend (subsequently medically confirmed) and describes the occurrence of DIARRHOEA (Severe diarrhoea), WEIGHT DECREASED (Weight loss 80 lbs) and NAUSEA (Nausea) in a male patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The patient's past medical history included Myocardial infarction, Congestive heart failure and Lung cancer. On an unknown date, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced DIARRHOEA (Severe diarrhoea) (seriousness criterion hospitalization), WEIGHT DECREASED (Weight loss 80 lbs) (seriousness criterion hospitalization) and NAUSEA (Nausea) (seriousness criterion hospitalization). At the time of the report, DIARRHOEA (Severe diarrhoea), WEIGHT DECREASED (Weight loss 80 lbs) and NAUSEA (Nausea) had not resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. No concomitant medications were reported. It was reported that the patient had recently undergone successful treatment for lung cancer and was doing well until shortly after receiving the vaccine. 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. The patient had to be hospitalized in the ICU following the onset of the adverse events and was being fed with a feeding tube. It was reported that multiple tests were conducted to diagnose the underlying cause for the events. No treatment medications were reported.; Sender'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: 1315883
Sex: F
Age: 49
State: TX

Vax Date: 04/07/2021
Onset Date: 04/07/2021
Rec V Date: 05/13/2021
Hospital: Y

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011L20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site pain, Pain

Symptoms: Urinary infection; burning sensation when urinating; The cough is still there; headach; Joint pain; muscle aches; Fatigue; Chills; Flu-like symptoms that lasted seven days; something came out between the axilla and chest; feel like powder in my throat; This spontaneous case was reported by a consumer (subsequently medically confirmed) and describes the occurrence of URINARY TRACT INFECTION (Urinary infection) in a 49-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 036A21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. Concomitant products included GABAPENTIN, TOPIRAMATE (TOPAMAX) and SULFAMETHOXAZOLE, TRIMETHOPRIM (SULFAMETHOXAZOLE AND TRIMETHOPRIM) for an unknown indication. On 07-Apr-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 05-May-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 07-Apr-2021, the patient experienced INFLUENZA LIKE ILLNESS (Flu-like symptoms that lasted seven days), AXILLARY MASS (something came out between the axilla and chest), OROPHARYNGEAL DISCOMFORT (feel like powder in my throat), COUGH (The cough is still there), HEADACHE (headach), ARTHRALGIA (Joint pain), MYALGIA (muscle aches), FATIGUE (Fatigue) and CHILLS (Chills). On 03-May-2021, the patient experienced URINARY TRACT INFECTION (Urinary infection) (seriousness criterion hospitalization) and DYSURIA (burning sensation when urinating). On 09-Apr-2021, HEADACHE (headach) had resolved. On 14-Apr-2021, INFLUENZA LIKE ILLNESS (Flu-like symptoms that lasted seven days) had resolved. At the time of the report, URINARY TRACT INFECTION (Urinary infection), OROPHARYNGEAL DISCOMFORT (feel like powder in my throat), DYSURIA (burning sensation when urinating), COUGH (The cough is still there), MYALGIA (muscle aches), FATIGUE (Fatigue) and CHILLS (Chills) outcome was unknown, AXILLARY MASS (something came out between the axilla and chest) had not resolved and ARTHRALGIA (Joint pain) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. Patient treated with Tylenol every 6 hours and Ibuprofen 200mg 2 tablets PO every 6 hours. Company comment: 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. This case was linked to US-MODERNATX, INC.-MOD-2021-114993 (E2B Linked Report).; Sender'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. US-MODERNATX, INC.-MOD-2021-114993:Original Case : MOD-2021-114900

Other Meds: GABAPENTIN; TOPAMAX; SULFAMETHOXAZOLE AND TRIMETHOPRIM

Current Illness:

ID: 1315884
Sex: F
Age:
State: DE

Vax Date: 01/28/2021
Onset Date: 03/05/2021
Rec V Date: 05/13/2021
Hospital: Y

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

Lab Data:

Allergies:

Symptom List: Injection site pain, Menorrhagia

Symptoms: Rhabdomyolysis with associated transaminitis from skeletal muscle breakdown; This spontaneous case was reported by an other health professional (subsequently medically confirmed) and describes the occurrence of RHABDOMYOLYSIS (Rhabdomyolysis with associated transaminitis from skeletal muscle breakdown) in a 67-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The patient's past medical history included Photopheresis (monthly) since an unknown date. Concurrent medical conditions included Graft versus host disease since 04-Oct-2019 and Weakness (frequently since 2018) since 2010. Concomitant products included RUXOLITINIB from 13-Jan-2021 to an unknown date for Graft versus host disease, PREDNISONE, BUDESONIDE and TACROLIMUS for an unknown indication. On 28-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 25-Feb-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 05-Mar-2021, the patient experienced RHABDOMYOLYSIS (Rhabdomyolysis with associated transaminitis from skeletal muscle breakdown) (seriousness criterion hospitalization). The patient was hospitalized from 05-Mar-2021 to 23-Mar-2021 due to RHABDOMYOLYSIS. On 23-Mar-2021, RHABDOMYOLYSIS (Rhabdomyolysis with associated transaminitis from skeletal muscle breakdown) had resolved. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): In March 2021, Aldolase: elevated (High) elevated levels consistent with myositis. In March 2021, Biopsy muscle: abnormal (abnormal) demonstrated mild myopathy, mitochondrial dysfunction, mild reinnervation and severe type 2 fiber atrophy. Microscopic analysis also demonstrated lymphocytic infiltration, along with apoptotic bodies, providing overall gestalt most consistent with a mixed nonspecific liver injury, along with some findings to support graft-versus-host-disease of the liver. In March 2021, Blood creatinine: elevated (High) elevated levels consistent with myositis. In March 2021, Electromyogram: abnormal (abnormal) consistent with myositis. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter considered RHABDOMYOLYSIS (Rhabdomyolysis with associated transaminitis from skeletal muscle breakdown) to be possibly related. Extensive serologic workup was done in March 2021 which were grossly negative for new autoimmune processes. No specific treatments were reported. Company Comment Based on current available information and the temporal association between product use and the start date of the events a causal relationship cannot be excluded.

Other Meds: RUXOLITINIB; PREDNISONE; BUDESONIDE; TACROLIMUS

Current Illness: Graft versus host disease; Photopheresis (monthly); Weakness (frequently since 2018)

ID: 1315885
Sex: M
Age: 31
State: IL

Vax Date: 10/14/2020
Onset Date:
Rec V Date: 05/13/2021
Hospital: Y

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

Lab Data:

Allergies:

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

Symptoms: grand maul seizure; vision changes; Feelings of pressure at the back of his neck radiating to right side of his head; This spontaneous case was reported by a physician (subsequently medically confirmed) and describes the occurrence of GENERALISED TONIC-CLONIC SEIZURE (grand maul seizure) in an adult male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. Co-suspect product included non-company product ADALIMUMAB (HUMIRA) solution for injection for Crohn's disease. Concurrent medical conditions included Crohn's disease (moderate to severe). On 14-Oct-2020, the patient started ADALIMUMAB (HUMIRA) (Subcutaneous) dosage form. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On an unknown date, the patient experienced GENERALISED TONIC-CLONIC SEIZURE (grand maul seizure) (seriousness criterion hospitalization), VISUAL IMPAIRMENT (vision changes) and NECK PAIN (Feelings of pressure at the back of his neck radiating to right side of his head). At the time of the report, GENERALISED TONIC-CLONIC SEIZURE (grand maul seizure) had resolved and VISUAL IMPAIRMENT (vision changes) and NECK PAIN (Feelings of pressure at the back of his neck radiating to right side of his head) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. The patient had a seizure three days after his first Moderna Covid vaccine and was hospitalized. CT scan was negative. The reporter's causality for co-suspect drug, adalimumab, was not provided. Concomitant product use was not provided. No treatment information was provided. This case concerns an adult male, with PMH of Crohn's disease, hospitalized with a serious unexpected event of generalized tonic-clonic seizure (grand mal seizure), and nonserious unexpected visual impairment and neck pain. Event onset with unknown latency after first dose mRNA-1273. 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.; Sender's Comments: This case concerns an adult male, with PMH of Crohn's disease, hospitalized with a serious unexpected event of generalized tonic-clonic seizure (grand mal seizure), and nonserious unexpected visual impairment and neck pain. Event onset with unknown latency after first dose mRNA-1273. 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: Crohn's disease (moderate to severe)

ID: 1315886
Sex: F
Age:
State: FL

Vax Date: 01/16/2021
Onset Date: 02/07/2021
Rec V Date: 05/13/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: I was having palpitations; the feeling was in upper part of stomach; I had difficulty breathing; The initial case was missing the following minimum criteria: No Adverse effect. Upon receipt of follow-up information on 12Feb2021, this case now contains all required information to be considered valid. This is a spontaneous report from a contactable Consumer (patient) A 84-years-old female patient (weight reported as '140' only) received the first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration on 16Jan2021 (at the age of 84) as single dose for covid-19 immunisation; denosumab (PROLIA), via an unspecified route of administration from 2019 and ongoing, cyclic, twice a year for osteoporosis. Medical history included osteoporosis. The patient's concomitant medications were not reported. The patient experienced palpitations, the feeling was in upper part of stomach (not in heart), difficulty breathing, all on 07Feb2021 at 20:00. No treatment received or hospital admission required. By bedtime she was able to fall asleep and awoke in the morning on 08Feb2021 and was fine. The events outcome was recovered on 08Feb2021. No follow-up attempts are possible; information about lot/batch number cannot be obtained

Other Meds: Prolia

Current Illness:

ID: 1315926
Sex: F
Age: 78
State: CA

Vax Date: 04/06/2021
Onset Date: 04/06/2021
Rec V Date: 05/13/2021
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: 1) Pain/soreness at injection site - Ongoing 2) Fever Blisters around mouth and lips - Ongoing 3) Large pustule under nose - now healed

Other Meds: N/A

Current Illness: None

ID: 1315927
Sex: M
Age: 45
State: CA

Vax Date: 05/11/2021
Onset Date: 05/11/2021
Rec V Date: 05/13/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: PATIENT RECEIVED COVID VACCINE MIXED WITH BACTERIOSTATIC 0.9% NORMAL SALINE INSTEAD OF PLAIN NORMAL SALINE 0.9%. THIS WAS DISCOVERED ON 5.12.21

Other Meds:

Current Illness:

ID: 1315928
Sex: F
Age: 35
State: NJ

Vax Date: 04/29/2021
Onset Date: 04/30/2021
Rec V Date: 05/13/2021
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

Symptom List: Nausea

Symptoms: Fever, chills, fatigue. Lung congestion for over 2 weeks (and it?s not breaking up)

Other Meds: Vitamin D3, multivitamin

Current Illness: None

ID: 1315929
Sex: M
Age: 32
State: CA

Vax Date: 05/11/2021
Onset Date: 05/11/2021
Rec V Date: 05/13/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Injection site pain

Symptoms: Patient received COVID vaccine mixed with bacteriostatic 0.9% normal saline instead of plain normal saline 0.9%. This was discovered on 5.12.2021.

Other Meds:

Current Illness:

ID: 1315930
Sex: F
Age: 41
State: AR

Vax Date: 05/12/2021
Onset Date: 05/13/2021
Rec V Date: 05/13/2021
Hospital:

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

Lab Data:

Allergies: Doxorubicin

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

Symptoms: This is my 2nd dose and I woke up in the night with my eye lid on fire it was burning stinging pain and eye lid was very swollen almost transparent looking from the swelling.

Other Meds: Tamoxifen 20mg everyday; Effexor 75mg everyday; Effexor 150mg everyday; Ibuprofen 200mg 2-4 tablets as needed for pain; Zyrtec 10mg as needed; Woman MultiVitamin everyday

Current Illness: None

ID: 1315931
Sex: F
Age: 72
State: CA

Vax Date: 05/11/2021
Onset Date: 05/11/2021
Rec V Date: 05/13/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: PATIENT RECEIVED COVID VACCINE MIXED WITH BACTERIOSTATIC 0.9% NORMAL SALINE INSTEAD OF PLAIN NORMAL SALINE 0.9%. THIS WAS DISCOVERED ON 5.12.21

Other Meds:

Current Illness:

ID: 1315932
Sex: F
Age: 33
State: CA

Vax Date: 05/12/2021
Onset Date: 05/13/2021
Rec V Date: 05/13/2021
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: no

Symptom List: Tremor

Symptoms: I had a chills and fever all night and the next morning, Sore body and armpits is majorly sore.

Other Meds: no

Current Illness: just a common cold.

ID: 1315933
Sex: F
Age: 33
State:

Vax Date: 05/05/2021
Onset Date: 05/08/2021
Rec V Date: 05/13/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Erythema, Pruritus

Symptoms: Diagnosed with COVID arm by my doctor?s office. Red, itchy rash surrounding the injection site on my left arm, and is about 3 inches long and 3.5 inches wide. The rash does not have any bumps I can see, but is itchy, red, and warmer to the touch than the rest of my arm.

Other Meds:

Current Illness:

ID: 1315934
Sex: M
Age: 35
State: MD

Vax Date: 05/08/2021
Onset Date: 05/09/2021
Rec V Date: 05/13/2021
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: - Nasacort - Claritin

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

Symptoms: Symptoms started approximately 14 hours post-vaccination. Day 1 symptoms: - Fever (<= 101.0 degrees F) - Chills - Headache - Fatigue/tiredness - Vomiting (one time exactly 24 hours post onset of symptoms) Days 2 - 5 symptoms: - Severe pain/tightness and fatigue feeling in both arms, shoulder blades, and chest. This has slowly improved over days 2 through 5. - Nausea associated with the pain/tightness noted above - Coughing (no phlegm) - Vomiting (one more time on day 2 exactly 24 hours after the first vomiting episode) - Fever and chills (both resolved by days 2-3) Treatments: - 500 mg Tylenol was used to treat fever and pain during the first several days. Fever was well controlled, but pain was only partially controlled - On days 3+ Advil was used for pain relief and it was effective - Alka Seltzer Gold was used to treat nausea as necessary. It was not particularly effective as the nausea seemed linked to the severity of the pain. When the pain eased, the nausea did as well. Outcomes: - Symptoms have slowly improved over the 5 days post 2nd dose vaccination. Advil has been discontinued since the afternoon of day 4. No fever is present and the pain is now only mild.

Other Meds: None

Current Illness: None

ID: 1315935
Sex: F
Age: 55
State: FL

Vax Date: 12/18/2020
Onset Date: 05/06/2021
Rec V Date: 05/13/2021
Hospital: Y

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

Lab Data:

Allergies: Cipro

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

Symptoms: Symptomatic covid 19: low grade fever , congestion, cough and SOB. Body aches and headaches.

Other Meds: Metformin, ozempic, jardiance, synthroid

Current Illness: None

ID: 1315936
Sex: F
Age: 36
State: FL

Vax Date: 05/01/2021
Onset Date: 05/13/2021
Rec V Date: 05/13/2021
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: None

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Swollen, red, hard, hot arm

Other Meds: Effexor, lamictal, biotin, magnesium, Allegra

Current Illness: None

ID: 1315937
Sex: F
Age: 52
State: LA

Vax Date: 05/04/2021
Onset Date: 05/04/2021
Rec V Date: 05/13/2021
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: temperature excursion with vaccine administration

Other Meds:

Current Illness:

ID: 1315938
Sex: F
Age: 57
State: NY

Vax Date: 05/10/2021
Onset Date: 05/11/2021
Rec V Date: 05/13/2021
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: none

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

Symptoms: 15 hours -ringing in ears began after first dose. Headache, chills, bodyaches- very bad in back, hips and stomach, fever of 101. Body rash. Ringing in ears became worse Drank lots of water prior to 2nd vaccine and following yet very dry mouth probably due to fever. Ate plenty of meals and fluids herbal teas and water. Fever broke at 48 hours. Headache stopped at 60 hours. Currently 78 hrs following second vaccine and still have body rash on back, chest, neck, stomach and ringing in ears.

Other Meds: none

Current Illness: none

ID: 1315940
Sex: F
Age: 31
State: CA

Vax Date: 05/10/2021
Onset Date: 05/11/2021
Rec V Date: 05/13/2021
Hospital:

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

Lab Data:

Allergies: Egg yoke

Symptom List: Pain in extremity

Symptoms: Lump between left collar bone and shoulder.

Other Meds: Ibuprofen and CBD balm

Current Illness: UTI, Syphilis

ID: 1315941
Sex: F
Age: 42
State: MO

Vax Date: 04/27/2021
Onset Date: 04/28/2021
Rec V Date: 05/13/2021
Hospital:

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

Lab Data:

Allergies: Poison ivy and oak

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

Symptoms: Fever (lasted 4 days), Nausea & diarrhea ( lasted 7 days) extreme fatigue (lasted 10 days), muscle and joint aches (9 days), drowsiness (lasted 8 days) This was much worse then the first injection. I could not complete ADLs such as work or household chores. The fatigue lasted the longest and was the worst symptom.

Other Meds: Zyrtec

Current Illness: None other than reaction to the first moderna vaccine

ID: 1315942
Sex: F
Age: 74
State: LA

Vax Date: 05/10/2021
Onset Date: 05/10/2021
Rec V Date: 05/13/2021
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: Temperature excursion with vaccine administered

Other Meds:

Current Illness:

ID: 1315943
Sex: F
Age: 28
State: TN

Vax Date: 04/07/2021
Onset Date: 04/08/2021
Rec V Date: 05/13/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: Total loss of appetite for more than a week.

Other Meds: None

Current Illness: None

ID: 1315944
Sex: M
Age: 16
State: TX

Vax Date: 05/11/2021
Onset Date: 05/11/2021
Rec V Date: 05/13/2021
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: No known allergies

Symptom List: Vomiting

Symptoms: Patient was accidentally given Modern vaccine, which is not approved for age 16. Pharmacist thought patient was going to be given Pfizer. Unknown symptoms at this time and parents are aware of what happened and monitoring.

Other Meds: Unknown

Current Illness:

ID: 1315945
Sex: M
Age: 30
State: LA

Vax Date: 05/06/2021
Onset Date: 05/06/2021
Rec V Date: 05/13/2021
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: temperature excursion with vaccine administered

Other Meds:

Current Illness:

ID: 1315946
Sex: M
Age: 35
State: CA

Vax Date: 05/11/2021
Onset Date: 05/12/2021
Rec V Date: 05/13/2021
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: Fever, chills, muscle ache, and headache began at 3:30 am the next day (17 hours after). Muscle ache persists as of May 13, 8:30 pm (58 hours after). Fever, chills, and muscle ache mostly resolved as of 6:00 am on May 13.

Other Meds:

Current Illness:

ID: 1315947
Sex: F
Age: 39
State:

Vax Date: 05/11/2021
Onset Date: 05/12/2021
Rec V Date: 05/13/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025j20-2A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Patient reports experiencing swelling of the left arm ( arm where the vaccine was given) from elbow down the following day after receiving the vaccine she also reports whole body hives starting 05/13/21. per pt took Tylenol but saw no relief

Other Meds:

Current Illness:

ID: 1315948
Sex: M
Age: 48
State: MN

Vax Date: 05/05/2021
Onset Date: 05/12/2021
Rec V Date: 05/13/2021
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

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

Symptoms: After 7 days I noticed a red mark / rash around the area the shot was given. It itches on and off. The area also feels swollen, like a lump. Was just reading about COVID-Arm, and it sounds like the same thing. While it's only been 7 days since my first shot, I'm going to continue to monitor, apply ice, and use Benadryl as needed, and if it doesn't go away in another week, will schedule a doctors appointment to be safe.

Other Meds: None

Current Illness: None

ID: 1315949
Sex: F
Age: 58
State: CO

Vax Date: 04/29/2021
Onset Date: 05/06/2021
Rec V Date: 05/13/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: Congestion, cough, whizzing, headaches, joint and body pain, loss of appetite, fever. Saw PCP and he prescribed the Butalbital Acctaminoplen,. Saw him a second time on 5/13/21 due to continued headaches and body aches.

Other Meds: Tylenol, Alka Seltzer, Butalbrtal Acctaminophen, Oxycodine .05mg

Current Illness: None

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm