VAERS 2021 Database www.vaers.hhs.gov

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

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

Incidents per State

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

ID: 1353772
Sex: F
Age: 20
State: TX

Vax Date: 04/16/2021
Onset Date: 05/14/2021
Rec V Date: 05/27/2021
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:

Symptom List: Dysphagia, Epiglottitis

Symptoms: Epileptic seizure; Twitching of the legs/Twitching of the arms/Her body would not stop twitching; Muscle spasm; Fever at 104 degrees Fahrenheit; This spontaneous case was reported by a consumer and describes the occurrence of EPILEPSY (Epileptic seizure), MUSCLE TWITCHING (Twitching of the legs/Twitching of the arms/Her body would not stop twitching), MUSCLE SPASMS (Muscle spasm) and PYREXIA (Fever at 104 degrees Fahrenheit) in a 20-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 008C21A and 008C21A) for COVID-19 vaccination. No medical history was reported. On 16-Apr-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On an unknown date, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 14-May-2021, the patient experienced EPILEPSY (Epileptic seizure) (seriousness criterion medically significant), MUSCLE TWITCHING (Twitching of the legs/Twitching of the arms/Her body would not stop twitching) (seriousness criterion medically significant), MUSCLE SPASMS (Muscle spasm) (seriousness criterion medically significant) and PYREXIA (Fever at 104 degrees Fahrenheit) (seriousness criterion medically significant). At the time of the report, EPILEPSY (Epileptic seizure), MUSCLE TWITCHING (Twitching of the legs/Twitching of the arms/Her body would not stop twitching), MUSCLE SPASMS (Muscle spasm) and PYREXIA (Fever at 104 degrees Fahrenheit) outcome was unknown. Patient received her second dose of the Moderna COVID-19 vaccine yesterday on 14MAY2021 at 10:30 AM. Patient experienced epileptic seizure, twitching of the arms, twitching of the legs, muscle spasm, and fever at 104 degrees Fahrenheit after receiving the second dose of the vaccine. She was sent to hospital twice yesterday. She came home last night from the hospital, went to sleep, and then she woke up around 4am screaming for his wife. Her body would not stop twitching and she kept punching herself with her arm. She went to the hospital again so they can calm her symptoms down. The emergency room doctors prescribed her medications for her shakiness and twitchiness. Her symptoms have been going on for 28 hours. The caller mentioned that the emergency room doctors did not know what to do with patient but to prescribe her medications to treat her symptoms. Patient was a healthy young girl until she got the second dose of the vaccine. Patient received the first dose of the Moderna COVID-19 vaccine on 16APR2021 and she experienced only experienced arm soreness for a couple days. No treatment information provided. No concomitant medication provided. Action taken with mRNA-1273 in response to the events was not applicable. 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 MOD-2021-132361 (Patient Link).; 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: 1353773
Sex: M
Age: 68
State: NJ

Vax Date: 04/06/2021
Onset Date: 05/06/2021
Rec V Date: 05/27/2021
Hospital: Y

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025L20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Anxiety, Dyspnoea

Symptoms: Clot; Stroke; Swelling began in the groin / swelling extending up to my upper thigh / swelling extending to the back; Problem with walking; Got mad and walked out of hospital byhimself; Nauseous; Pins and needles sensation; Felt chilly; Dizzy; Whole body(left side) went numb; This spontaneous case was reported by a consumer and describes the occurrence of SWELLING (Swelling began in the groin / swelling extending up to my upper thigh / swelling extending to the back), THROMBOSIS (Clot) and CEREBROVASCULAR ACCIDENT (Stroke) in a 68-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 030A21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 06-Apr-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 06-May-2021, the patient experienced SWELLING (Swelling began in the groin / swelling extending up to my upper thigh / swelling extending to the back) (seriousness criterion hospitalization), FEELING COLD (Felt chilly), DIZZINESS (Dizzy), HYPOAESTHESIA (Whole body(left side) went numb), PARAESTHESIA (Pins and needles sensation) and NAUSEA (Nauseous). On 07-May-2021, the patient experienced THROMBOSIS (Clot) (seriousness criteria hospitalization and medically significant), CEREBROVASCULAR ACCIDENT (Stroke) (seriousness criteria hospitalization and medically significant), GAIT DISTURBANCE (Problem with walking) and TREATMENT NONCOMPLIANCE (Got mad and walked out of hospital byhimself). The patient was hospitalized on 07-May-2021 due to CEREBROVASCULAR ACCIDENT and THROMBOSIS. At the time of the report, SWELLING (Swelling began in the groin / swelling extending up to my upper thigh / swelling extending to the back), THROMBOSIS (Clot), CEREBROVASCULAR ACCIDENT (Stroke), FEELING COLD (Felt chilly), DIZZINESS (Dizzy), HYPOAESTHESIA (Whole body(left side) went numb), GAIT DISTURBANCE (Problem with walking), PARAESTHESIA (Pins and needles sensation), TREATMENT NONCOMPLIANCE (Got mad and walked out of hospital byhimself) and NAUSEA (Nauseous) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 07-May-2021, Blood test: unknown (Inconclusive) Unknown. On 07-May-2021, Computerised tomogram: unknown (Inconclusive) Unknown. On 07-May-2021, Magnetic resonance imaging: unknown (Inconclusive) Unknown. On 07-May-2021, X-ray: unknown (Inconclusive) Unknown. Company comment: Although a temporal association exists, provided information is not adequate to assess the causal association between the events of thrombosis, stroke, swelling, hypoesthesia, paresthesia, gait disturbance and mRNA-1273. The detailed medical history and diagnostic report has not been provided. Based on the current available information and temporal association between the use of the product and the start date of the events of dizziness, feeling cold, nausea, a causal relationship cannot be excluded. The causality assessment for the event of Treatment noncompliance remains Not applicable. This case was linked to MOD-2021-133656 (Patient Link).; Sender's Comments: Although a temporal association exists, provided information is not adequate to assess the causal association between the events of thrombosis, stroke, swelling, hypoesthesia, paresthesia, gait disturbance and mRNA-1273. The detailed medical history and diagnostic report has not been provided. Based on the current available information and temporal association between the use of the product and the start date of the events of dizziness, feeling cold, nausea, a causal relationship cannot be excluded. The causality assessment for the event of Treatment noncompliance remains Not applicable.

Other Meds:

Current Illness:

ID: 1353774
Sex: F
Age:
State: MS

Vax Date:
Onset Date:
Rec V Date: 05/27/2021
Hospital: Y

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:

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

Symptoms: Severely ill; Body aches; Fever; Chills; Nausea; This spontaneous case was reported by a health care professional (subsequently medically confirmed) and describes the occurrence of CRITICAL ILLNESS (Severely ill), PAIN (Body aches), PYREXIA (Fever), CHILLS (Chills) and NAUSEA (Nausea) 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. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced CRITICAL ILLNESS (Severely ill) (seriousness criteria hospitalization and medically significant), PAIN (Body aches) (seriousness criterion hospitalization), PYREXIA (Fever) (seriousness criterion hospitalization), CHILLS (Chills) (seriousness criterion hospitalization) and NAUSEA (Nausea) (seriousness criterion hospitalization). At the time of the report, CRITICAL ILLNESS (Severely ill), PAIN (Body aches), PYREXIA (Fever), CHILLS (Chills) and NAUSEA (Nausea) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, COVID-19: positive (Positive) Positive. On an unknown date, Oxygen saturation: decreased (Low) Decreased. 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 drugs were reported. No treatment information was provided. 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. The patient's history of COVID infection just before the vaccination remains a confounder. Patient had COVID before vaccine.after her isolation was over she received 1st dose; she got severely ill; she had fever, chills , body aches , nausea , and she was in the hospital on temporally oxygen. Patient wants to know when she can get the 2nd dose of the vaccine and is it safe to take second vaccine?; 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 patient's history of COVID infection just before the vaccination remains a confounder.

Other Meds:

Current Illness:

ID: 1353775
Sex: F
Age:
State: NY

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

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

Lab Data:

Allergies:

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Heart pain; pneumonia-like symptoms; Flue symptoms; Aching; Extreme fatigue; This spontaneous case was reported by a consumer and describes the occurrence of ANGINA PECTORIS (Heart pain) in a 22-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. Unknown) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. Concurrent medical conditions included Kidney disorder. On 05-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 05-May-2021, the patient experienced ANGINA PECTORIS (Heart pain) (seriousness criterion medically significant), RESPIRATORY SYMPTOM (pneumonia-like symptoms), INFLUENZA LIKE ILLNESS (Flue symptoms), MYALGIA (Aching) and FATIGUE (Extreme fatigue). At the time of the report, ANGINA PECTORIS (Heart pain), RESPIRATORY SYMPTOM (pneumonia-like symptoms), INFLUENZA LIKE ILLNESS (Flue symptoms), MYALGIA (Aching) and FATIGUE (Extreme fatigue) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 17-May-2021, Echocardiogram: normal (normal) normal. The patient went to emergency department and everything was normal. The reporter stated that the patient was better with nitroglycerine. No concomitant medications were reported. Treatment for the events included nitroglycerine. 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: Kidney disorder

ID: 1353776
Sex: F
Age: 67
State: MI

Vax Date: 04/21/2021
Onset Date: 04/21/2021
Rec V Date: 05/27/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: tested positive for Covid-19; I took her in to see the Dr for a urinary tract infection; sore arm; This spontaneous case was reported by a consumer (subsequently medically confirmed) and describes the occurrence of SARS-COV-2 TEST POSITIVE (tested positive for Covid-19) in a 67-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 002C21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 21-Apr-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 21-Apr-2021, the patient experienced PAIN IN EXTREMITY (sore arm). On 30-Apr-2021, the patient experienced SARS-COV-2 TEST POSITIVE (tested positive for Covid-19) (seriousness criterion medically significant) and URINARY TRACT INFECTION (I took her in to see the Dr for a urinary tract infection). At the time of the report, SARS-COV-2 TEST POSITIVE (tested positive for Covid-19), URINARY TRACT INFECTION (I took her in to see the Dr for a urinary tract infection) and PAIN IN EXTREMITY (sore arm) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 30-Apr-2021, SARS-CoV-2 test: positive (Positive) positive. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Concomitant medication was not reported. It was reported that the patient had been feeling weak a few days before getting the vaccine. Patient was treated with one dose of IV Bamlanivimab etesevimab to treat Covid.and was sent home. Company comment: SARS-CoV-2 test: positive is assessed as unlikely related to mRNA-1273. Based on the current available information and temporal association between the use of the product and the start date of the rest of the events, a causal relationship cannot be excluded. This case was linked to US-MODERNATX, INC.-MOD-2021-138839, US-MODERNATX, INC.-MOD-2021-138859 (E2B Linked Report).; Sender's Comments: SARS-CoV-2 test: positive is assessed as unlikely related to mRNA-1273. Based on the current available information and temporal association between the use of the product and the start date of the rest of the events, a causal relationship cannot be excluded. US-MODERNATX, INC.-MOD-2021-138859: US-MODERNATX, INC.-MOD-2021-138839:Crosslink

Other Meds:

Current Illness:

ID: 1353777
Sex: U
Age:
State:

Vax Date: 01/01/2021
Onset Date: 02/01/2021
Rec V Date: 05/27/2021
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:

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

Symptoms: MS symptoms; tingling; pain; feeling like crap; constantly tired; This spontaneous case was reported by a consumer and describes the occurrence of MULTIPLE SCLEROSIS (MS symptoms) in a 62-year-old patient of an unknown gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. Concurrent medical conditions included Psoriatic arthritis. Concomitant products included ADALIMUMAB (HUMIRA) for Psoriatic arthritis. In January 2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 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. In February 2021, the patient experienced MULTIPLE SCLEROSIS (MS symptoms) (seriousness criterion medically significant), PARAESTHESIA (tingling), PAIN (pain), VACCINATION COMPLICATION (feeling like crap) and FATIGUE (constantly tired). At the time of the report, MULTIPLE SCLEROSIS (MS symptoms), PARAESTHESIA (tingling), PAIN (pain), VACCINATION COMPLICATION (feeling like crap) and FATIGUE (constantly tired) had not resolved. No laboratory data was provided. No treatment information was provided. The patient received both scheduled doses of mRNA-1273 prior to the events, therefore action taken with the drug in response to the events was not applicable. Company comment: Very limited information regarding these events have been provided at this time. No further information is expected. This case was linked to MOD-2021-139228 (Patient Link).; Sender's Comments: Very limited information regarding these events have been provided at this time. No further information is expected.

Other Meds: HUMIRA

Current Illness: Psoriatic arthritis

ID: 1353778
Sex: M
Age: 39
State: NM

Vax Date: 02/25/2021
Onset Date: 02/25/2021
Rec V Date: 05/27/2021
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:

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: hospitalized after the first dose for over a month; Patient received three doses of Moderna Covid 19 vaccine; This spontaneous case was reported by a pharmacist and describes the occurrence of HOSPITALISATION (hospitalized after the first dose for over a month) in a 40-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 031M20A, 045A21A and 027C21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. Concomitant products included FLUTICASONE, TRAZODONE, PROPRANOLOL HYDROCHLORIDE (PROPRANOLOL [PROPRANOLOL HYDROCHLORIDE]), LITHIUM CARBONATE, NORTRIPTYLINE, BENZONATATE (TESSALON PERLE), HALOPERIDOL and CLONAZEPAM for an unknown indication. On 25-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 15-Apr-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 13-May-2021, received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 25-Feb-2021, the patient experienced HOSPITALISATION (hospitalized after the first dose for over a month) (seriousness criterion hospitalization). On 13-May-2021, the patient experienced INCORRECT DOSE ADMINISTERED (Patient received three doses of Moderna Covid 19 vaccine). The patient was hospitalized from sometime in 2021 to sometime in 2021 due to HOSPITALISATION. On 13-May-2021, INCORRECT DOSE ADMINISTERED (Patient received three doses of Moderna Covid 19 vaccine) had resolved. At the time of the report, HOSPITALISATION (hospitalized after the first dose for over a month) 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. Reason for hospital admission was not reported. Company comment: This report refers to a case of Expired Product Administered for mRNA-1273 (Lot #: ) with the event of "Hospitalisation'. Very limited information regarding Hospitalisation has been provided at this time. Further information is not expected no associated adverse events. This case was linked to MOD-2021-141479 (Patient Link).; Sender's Comments: This report refers to a case of Expired Product Administered for mRNA-1273 (Lot #: ) with the event of "Hospitalisation'. Very limited information regarding Hospitalisation has been provided at this time. Further information is not expected no associated adverse events.

Other Meds: FLUTICASONE; TRAZODONE; PROPRANOLOL [PROPRANOLOL HYDROCHLORIDE]; LITHIUM CARBONATE; NORTRIPTYLINE; TESSALON PERLE; HALOPERIDOL; CLONAZEPAM

Current Illness:

ID: 1353779
Sex: M
Age: 39
State: NM

Vax Date: 02/25/2021
Onset Date: 02/25/2021
Rec V Date: 05/27/2021
Hospital: Y

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: Pharyngeal swelling

Symptoms: hospitalized after the first dose for over a month; Patient received three doses of Moderna Covid 19 vaccine; This spontaneous case was reported by a pharmacist and describes the occurrence of HOSPITALISATION (hospitalized after the first dose for over a month) in a 40-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 031M20A, 045A21A and 027C21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No medical history reported by the reporter. Concomitant products included FLUTICASONE, TRAZODONE, PROPRANOLOL (PROPANOLOL [PROPRANOLOL]), LITHIUM CARBONATE, NORTRIPTYLINE, BENZONATATE, HALOPERIDOL and CLONAZEPAM for an unknown indication. On 25-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 15-Apr-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 13-May-2021, received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 25-Feb-2021, the patient experienced HOSPITALISATION (hospitalized after the first dose for over a month) (seriousness criterion hospitalization). On 13-May-2021, the patient experienced OVERDOSE (Patient received three doses of Moderna Covid 19 vaccine). On 13-May-2021, OVERDOSE (Patient received three doses of Moderna Covid 19 vaccine) had resolved. At the time of the report, HOSPITALISATION (hospitalized after the first dose for over a month) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. Treatment information were not provided. Action taken with mRNA-1273 in response to the event was not applicable. Company comment: This report refers to a case of Overdose for mRNA-1273 (Lot #: 031M20A, 045A21A and 027C21A) with the event of "Hospitalisation'. Very limited information regarding Hospitalisation has been provided at this time. Further information is not expected This case was linked to MOD-2021-141444 (Patient Link).; Sender's Comments: This report refers to a case of Overdose for mRNA-1273 (Lot #: 031M20A, 045A21A and 027C21A) with the event of "Hospitalisation'. Very limited information regarding Hospitalisation has been provided at this time. Further information is not expected

Other Meds: FLUTICASONE; TRAZODONE; PROPANOLOL [PROPRANOLOL]; LITHIUM CARBONATE; NORTRIPTYLINE; BENZONATATE; HALOPERIDOL; CLONAZEPAM

Current Illness:

ID: 1353780
Sex: M
Age: 29
State: NJ

Vax Date: 04/14/2021
Onset Date: 04/17/2021
Rec V Date: 05/27/2021
Hospital: Y

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: Swelling in the brain; Blurred vision; Weakness in the hand; Difficulty walking; This spontaneous case was reported by a consumer (subsequently medically confirmed) and describes the occurrence of BRAIN OEDEMA (Swelling in the brain), VISION BLURRED (Blurred vision), MUSCULAR WEAKNESS (Weakness in the hand) and GAIT DISTURBANCE (Difficulty walking) in a 29-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 032M20A) for COVID-19 vaccination. No Medical History information was reported. On 14-Apr-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 17-Apr-2021, the patient experienced BRAIN OEDEMA (Swelling in the brain) (seriousness criteria hospitalization and medically significant), VISION BLURRED (Blurred vision) (seriousness criterion hospitalization), MUSCULAR WEAKNESS (Weakness in the hand) (seriousness criterion hospitalization) and GAIT DISTURBANCE (Difficulty walking) (seriousness criterion hospitalization). At the time of the report, BRAIN OEDEMA (Swelling in the brain), VISION BLURRED (Blurred vision), MUSCULAR WEAKNESS (Weakness in the hand) and GAIT DISTURBANCE (Difficulty walking) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): In 2021, Magnetic resonance imaging head: abnormal (abnormal) He had a brain MRI which shows swelling in the brain. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Concomitant product was not taken by the patient. Treatment information was not provided. The patient has weakness in his hand, difficulty walking, blurred vision. The patient started experiencing symptoms 3 days later, and they are ongoing. The patient was hospitalized for these symptoms, and was given steroids to reduce the swelling. Company Comment: Very limited information regarding these events has been provided at this time. Further information has been requested.; 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: 1353781
Sex: F
Age: 58
State: VA

Vax Date: 05/11/2021
Onset Date: 05/12/2021
Rec V Date: 05/27/2021
Hospital: Y

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: Possible stroke symptoms; This spontaneous case was reported by a consumer (subsequently medically confirmed) and describes the occurrence of CEREBROVASCULAR ACCIDENT (Possible stroke symptoms) in a 58-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 11-May-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 12-May-2021, the patient experienced CEREBROVASCULAR ACCIDENT (Possible stroke symptoms) (seriousness criteria hospitalization and medically significant). The patient was hospitalized from 12-May-2021 to 15-May-2021 due to CEREBROVASCULAR ACCIDENT. The patient was treated with ACICLOVIR SODIUM (ACYCLOVIR [ACICLOVIR SODIUM]) ongoing since an unknown date for Stroke, at a dose of 800 milligram; ATORVASTATIN CALCIUM (LIPITOR) ongoing since an unknown date for Stroke, at a dose of UNK dosage form; FENOFIBRATE ongoing since an unknown date for Stroke, at a dose of 54 milligram and PREDNISONE ongoing since an unknown date for Stroke, at a dose of 10 milligram. At the time of the report, CEREBROVASCULAR ACCIDENT (Possible stroke symptoms) had not resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Company comment: 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:

Current Illness:

ID: 1353784
Sex: U
Age:
State: IN

Vax Date:
Onset Date:
Rec V Date: 05/27/2021
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: Only one component of the vaccine was given to patient, the solution component which as the Tdap/ no AE; Based on information previously received on 21-Jan-2021, the following information [case classification from Non-Valid to Valid Agency with no AE and update in narrative accordingly; company drug code Pentacel from 242 to 520 updated and latency as one day in the field and update in narrative accordingly] have been amended. Initial information was received on 21-Jan-2021 regarding an unsolicited valid non-serious case via Agency (Reference number- 00439658) from a pharmacist. This case involves a patient of unknown age and gender who was vaccinated with DIPHTHERIA/TETANUS/5 HYBRID AC PERTUSSIS/IPV(MRC5)/HIB(PRP/T) VACCINE [PENTACEL] however, only one component of the vaccine was given, the solution component which as the Tdap (product preparation issue) via an unknown route at an unknown administration site on an unknown date for prophylactic vaccination. It was a case of an actual medication error due to inappropriate reconstitution technique (latency was on same day). At the time of reporting, no adverse event reported. The reporter said that whether they can reconstitute the powder portion of the vaccine and was it safe to give another dose to patient. This suspected adverse reaction report is submitted and classified as a medication error solely and exclusively to ensure the marketing authorization holder's compliance with the requirements set out in Directive 2001/83/EC and Module VI of the Good Pharmacovigilance Practices. The classification as a medical error is in no way intended, nor should it be interpreted or construed as an allegation or claim made by the marketing authorization holder that any third party has contributed to or is to be held liable for the occurrence of this medication error. There will be no information available on batch number for this case.

Other Meds:

Current Illness:

ID: 1353839
Sex: F
Age:
State:

Vax Date: 01/08/2021
Onset Date: 01/09/2021
Rec V Date: 05/27/2021
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: COVID19

Other Meds:

Current Illness:

ID: 1354093
Sex: U
Age: 33
State:

Vax Date: 05/25/2021
Onset Date: 05/25/2021
Rec V Date: 05/27/2021
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: Blood pressure decreased, Chest pain, Chills, Confusional state, Decreased appetite

Symptoms: Patient was feeling light headed b/p was 108/70; Patient refused to be transported.

Other Meds:

Current Illness:

ID: 1354094
Sex: M
Age: 14
State: UT

Vax Date: 05/17/2021
Onset Date: 05/25/2021
Rec V Date: 05/27/2021
Hospital: Y

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: NKA

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

Symptoms: Received COVID vaccine on 5/17/21 5/25/21 around 0100 patient collapsed with acute onset right sided weakness and expressive aphasia. Brought to an ED where CTA found an occlusion of the L MCA which was confirmed as a ischemic stroke. He received TPA and underwent a IR guided thrombectomy. Patient continues to be admitted to the PICU with intermittent expressive aphasia and mild right sided weakness.

Other Meds: Aspirin 81mg PO daily Sildenafil 20mg PO BID Vitamin B complex capsule daily Vitamin C 25mg oral tablet daily Vitamin D with minerals oral tablet daily

Current Illness: n/a

ID: 1354095
Sex: F
Age: 17
State: PA

Vax Date: 05/26/2021
Onset Date: 05/26/2021
Rec V Date: 05/27/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Less than 1 minute after received the shot, patient became clammy and pale while sitting in chair. Her eyes rolled back in her head and her body went slack. Myself (parent) and the nurse who had given the shot braced her on either side while she appeared to fade in and out of consciousness for several minutes (she seemed to occasionally interact with us, mumbling responses to 'yes' or 'no' questions). The nurse did not want to lower her to the floor, but wanted to keep her propped on the chair. Her head kept rolling to the side. At one point, she began to jerk rhythmically. Just as I was about to bring this to the attention of the nurse, the patient returned to consciousness. Patient was moved to a rolling recliner chair and taken to a recovery area where I (parent) did not see her for another 30 minutes as I was receiving my own shot. The chair she had sat in was wet, but it was assumed this was due to sweat (patient had sweated profusely). On the way out of the clinic, noticing a wet stain on the back side of patient's pants, I asked if she had wet her pants (quietly) two separate times. Patient denied it both times. However, upon returning home, patient confirmed that she had wet her pants. Patient was monitored during the evening for similar adverse events ; none noted. Patient ate lunch approximately 1 hour before receiving shot and was given crackers while at clinic. Patient is a well-hydrated individual, and also drank water while on-site. No fever either before or after shot. A slightly elevated BP the next day (135/83). However, patient complained of headache, fatigue, and pain at injection location; elevated BP may be related to headache and/or ordeal from day of the shot.

Other Meds: Propanolol, Zyrtec, Maxalt (as needed)

Current Illness:

ID: 1354096
Sex: F
Age: 61
State: IL

Vax Date: 05/25/2021
Onset Date: 05/25/2021
Rec V Date: 05/27/2021
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: cyclobenzaprine, ketamine, ketoralac, prochlorperazine, latex,

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

Symptoms: NO SYMPTOMS BUT MONITORING FOR 14 DAYS PER MD

Other Meds: none

Current Illness: VASCULAR DEMENTIA WITHOUT BEHAVIORAL DISTURBANCE. HX OF FALLS

ID: 1354098
Sex: F
Age: 62
State: CA

Vax Date: 02/27/2021
Onset Date: 04/08/2021
Rec V Date: 05/27/2021
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: morphine, cippro

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

Symptoms: April 7 I got the worst case of eczema ever. Only get it occasionally, say every couple of years. This was face, neck, arms, stomach, thigh and butt. Then May 15v got Shingles. Still dealing with severe pain.

Other Meds: BVitamins A, B12, B2, C, D, fish oil, baby aspirin, magnesium Imetrex, nortriptyline

Current Illness: none

ID: 1354099
Sex: F
Age: 32
State: WA

Vax Date: 05/26/2021
Onset Date: 05/27/2021
Rec V Date: 05/27/2021
Hospital:

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

Lab Data:

Allergies: sensitivity to dairy and coco

Symptom List: Ear pain, Hypoaesthesia

Symptoms: sore arm around injection area, swelling in arm and armpit, red blotchy rash around injection area, headache, flu-like body aches, tiredness

Other Meds: none

Current Illness: n/a

ID: 1354100
Sex: F
Age: 73
State: KY

Vax Date: 03/10/2021
Onset Date: 03/12/2021
Rec V Date: 05/27/2021
Hospital:

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

Lab Data:

Allergies: NKDA

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Patient reports coming in for second dose of Moderna vaccine on 3/10/2021 and was given a J&J vaccine in error. Patients report 4-5 episodes of diarrhea daily every day since 3/12/2021. Patient states she just recently went to see family doctor and a stool sample was sent off but has not yet resulted. Patient denies any other problems. Spoke to nurse who administered vaccine. She stated that online immunization registery was down and pateint was asked prior to getting vaccine if she had ever received vaccine in the past and responded "no." Once immunization registry was back up it was discovered the patient had had first dose of Moderna on 2/10/2021. Medical Director was consulted and patient was informed of error while still in observation period. Observation period was extended.

Other Meds: Blood pressure medication

Current Illness: None

ID: 1354101
Sex: M
Age: 17
State: NY

Vax Date: 05/19/2021
Onset Date: 05/24/2021
Rec V Date: 05/27/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: Patient hospitalized for overdose. Patient found to have potential myocarditis. Patient overdosed on antihistamines loratadine and doxylamine. Found to have rhabdomyolysis. CK levels have been trending downward. Patient found to have elevated troponin and ECHO showed decreased EF raising concern for myocarditis. Also with EKG changes. Patient is asymptomatic without chest pain or palpitations. Cannot differentiate cause of myocarditis, can be due to over dose and related to rhabdomyolysis or other causes.

Other Meds: None

Current Illness: None

ID: 1354102
Sex: F
Age: 73
State: NV

Vax Date: 03/15/2021
Onset Date: 03/15/2021
Rec V Date: 05/27/2021
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: nka

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

Symptoms: she had fatigue and was not feeling well the day of taking the Vax. Pt had pain that started in the lower back, moved to the groin, down to thighs and then switched and moved down to the right ankle. She then developed a swollen right foot. On 3/22/21 she went to her doctors office and saw an alternate physician at Medical Group. She was prescribed a 10mg pain killer along w/Tylenol. On 3/25/21 she went to Emergency Center. She had x-rays. She was diagnosed w/ chronic right sided lumbar radiculopathy, poly articular arthritis and spondylolisthesis of the lumbar region. She was told to FU w/ a pain specialist and PCP. She saw Dr. on 4/9/2021 and was told it maybe gout so ordered lab test and prescribed steroids. Around 4/12/21 she saw another Dr. at a Spine and Pain specialist. She was just told to come back if she had another flare up. On 5/13/2021 she had lower back pain flare up so went back to PCP Dr. . She upped her gabapentin medication to 300 mg and referred her back to Pain Specialist. On 5/26/2021 she went back and was given steroid injections. She will FU Dr. on 6/14/21.

Other Meds: levothyroxine 50mcc, olmesartan medoxil 40mg, omeprazole 20mg, duloxetine 20mg, osteobioflex, glucosamine triple strength, calcium w/ magnesium and zinc, B Complex 100mg, Omega369 500mg,

Current Illness:

ID: 1354103
Sex: F
Age: 45
State:

Vax Date: 05/04/2021
Onset Date: 05/04/2021
Rec V Date: 05/27/2021
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: Lightheadedness.

Other Meds:

Current Illness:

ID: 1354104
Sex: F
Age: 19
State: MA

Vax Date: 02/05/2021
Onset Date: 05/18/2021
Rec V Date: 05/27/2021
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: Bactrim

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

Symptoms: Sore throat, swollen glands, swollen tonsils

Other Meds: Larissa, Celexa

Current Illness: None

ID: 1354106
Sex: M
Age: 65
State: WY

Vax Date: 05/21/2021
Onset Date: 05/22/2021
Rec V Date: 05/27/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Injection site pain, Pain

Symptoms: PATEINT RECEIVED THE VACCINATION ON 5/21/2021 AT 1330 HOURS. BY 5/22/2021 HE HAS REPORTED THAT HE HAS DEVELOPED PERIPHERAL NEUROPATHY IN BOTH OF HIS HANDS THAT HAS PROGRESSIVELY GOTTEN WORSE OVER THE LAST 6 DAYS. TODAY HIS HANDS HURT SO BAD THAT HE CAN HARDLE ZIP UP HIS PANTS AND CANNOT LIFT MOST OPTIONS. ANYTHING THAT PUTS ANY PRESSURE ON HIS FINGERS OR HANDS CAUSES PAIN. AT THIS TIME, I AM GOING TO CONTACT HIS PHYSICIAN TO SEE IF INCREASING HIS GABAPENTIN WILL BE OF ANY BENEFIT AND IN THE MEANTIME WE ARE STARTING SCHEDULED APAP 1000 MG QID AND NAPROXEN 440 PO BID-TID UNTIL A PHYSICIAN CONSULT CAN BE MADE. CONDITION DOES NOT APPEAR TO BE LIFE THREATENING AT THIS TIME, HOWEVER THE PATIENT IS EXTREMELY DISABLED AT THIS POIN AS USE OF EITHER HAND FOR COMPLETION OF DAILY ACTIVITES IS EXTEREMLY LIMITED.

Other Meds:

Current Illness:

ID: 1354107
Sex: M
Age: 40
State: CA

Vax Date: 05/25/2021
Onset Date: 05/25/2021
Rec V Date: 05/27/2021
Hospital:

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

Lab Data:

Allergies: NKDA

Symptom List: Injection site pain, Menorrhagia

Symptoms: Pt. was sent from training to Dialysis to receive 2nd dose of COVID vaccine. Pt. did not have vaccination card on hand, did not remember what brand vaccine he received nor did RN ask prior to departure. Pt. arrived at Dialysis and was administered Moderna vaccine. Pt. received initial Pfizer vaccine on 4/20/2021 at County Department of Public Health. Pt. aware of circumstances and states he told RN at Dialysis "I had Pfizer, my first dose was Pfizer". RN monitoring pt. is asymptomatic.

Other Meds:

Current Illness:

ID: 1354108
Sex: F
Age: 63
State: ID

Vax Date: 04/08/2021
Onset Date: 04/08/2021
Rec V Date: 05/27/2021
Hospital:

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

Lab Data:

Allergies: allergies to a lot of antibiotics

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

Symptoms: About 15 mins after injection my legs started itching, and I felt slightly disoriented, dizzy. I did feel like it wouldn't be smart to drive so my husband drove me home. I had a slight fever that night and next day, I felt super tired. I scheduled an ultrasound for 1 week following the shot, My ears kind of freaked out after the ultrasound and was itching and burning, I also got a rash around my neck after ultrasound. The rash felt like fire. Allegra helped with the itching. Faint rash traveled down my arms. The Dr. put me on prednisone the rash spread to my back and upper legs. Benadryl was not helpful. It lasted approximately 2 weeks.

Other Meds: estrogen, progestrone

Current Illness: none

ID: 1354109
Sex: F
Age: 36
State: HI

Vax Date: 05/08/2021
Onset Date: 05/09/2021
Rec V Date: 05/27/2021
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: antihistamines; onions

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: I had flu like symptoms for 24 hours afterwards. My arm swelled up from shoulder to elbow. I had a bright red rash that started to go away and then came back and got worse over two weeks. I have a half dollar size lump at the injection site that showed up 24 hours after the vaccine - hard like bone. Not hard like a muscle knot or something. Hot to touch - the whole rash area and itching. I went to Urgent care on the 21st -after it didn't go away in two weeks. They prescribed Cephalexin to take 1000 mg twice a day for a week. The rash is mostly gone and heat is gone but lump is still there. And followed up on Sunday 29th. The doctor said that the hard lump might be permanent. Doctor said the rash part looked like Cellulitis. Rash and fever are gone but lump is still there.

Other Meds: Levothyroxine

Current Illness: no

ID: 1354110
Sex: F
Age: 73
State: NY

Vax Date: 01/21/2021
Onset Date: 01/21/2021
Rec V Date: 05/27/2021
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: She got her vaccine, felt a little pain at the injection site, waited the 15 minutes and walked home. Once she got home she noticed her arm was sore, but didn't think much of it. Around 4 hours later around 6:00 PM she went to make dinner and her neck was so stiff she could not move it to the right. When she was able to move her neck it hurt a lot. The arm started to hurt more, and the whole left side of her body started to hurt from her neck down to her stomach. Then when she was in the bed around 9:00 and she likes to sleep on her left side, and the pain was so bad that she could not sleep on her left arm and put her head on top of the pillow and sleep at all. When she woke up the next day everything was still very stiff, her neck was and could not really move it or move the left arm to the right due to severe pain. That night she was finally able to sleep on her left side. Then probably by the 3rd day it was getting a lot better. No fever, chills, or any other reactions, just the arm pain and neck stiffness. She was in pretty bad pain. She then got her 2nd vaccine and was okay at that time, and had no reaction at all to that one and actually thought that she did not get it at all. She had told the nurse about the reaction and the 2nd nurse was very gentle with her. She did not go home right away and felt just a little bit of a prick in her left arm. She then went to 2 stores as she felt well.

Other Meds: Tylenol, vitamin C, Vitamin E, Vitamin B12, Hydroxycut, Vitamin D, Centrum silver.

Current Illness: None.

ID: 1354111
Sex: F
Age: 27
State:

Vax Date: 05/24/2021
Onset Date: 05/24/2021
Rec V Date: 05/27/2021
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: Lightheadedness.

Other Meds:

Current Illness:

ID: 1354113
Sex: F
Age: 90
State: NJ

Vax Date: 04/23/2021
Onset Date: 05/14/2021
Rec V Date: 05/27/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Nausea

Symptoms: Second dose given 21 days after 1st dose. Patient reports on 5/21/21 that she feels great and she has had no signs and symptoms to report other than a slight sore arm at the injection site lasting only for a few hours the first night.

Other Meds:

Current Illness:

ID: 1354114
Sex: M
Age: 53
State: OR

Vax Date: 05/16/2021
Onset Date: 05/23/2021
Rec V Date: 05/27/2021
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 reported signs and symptoms of SOB/right leg pain 1 week after receiving the Moderna vaccine. He stated that he was "breathing fire" and woke up with an extremely painful and swollen leg. Upon coming to the ED, it was found to be bilateral PE and right leg DVT.

Other Meds: Bisacodyl, diphenhydramine, escitalopram, fluticasone, metformin, nicotine lozenges, omeprazole, propranolol, ropinirole, trazodone

Current Illness:

Date Died: 05/06/2021

ID: 1354115
Sex: M
Age: 67
State: VT

Vax Date: 02/26/2021
Onset Date: 03/10/2021
Rec V Date: 05/27/2021
Hospital: Y

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

Lab Data:

Allergies: no, just to dogs, cats, etc no medication, food, or other products allergies that we are aware of

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

Symptoms: MIGHT NOT BE LINKED TO VACCINE but, please, watch for Bacterial Endocarditis following Covid vaccinations. On-set following vaccination seems suspicious but might be coincidental. He died of Bacterial Endocarditis on May 6, 2020. First weird symptoms began March 10, very slight chills after going out for a walk. He had had pretty strong flu-like symptoms began 4 1/2 days after first vaccine dose and lasted 5 1/2 to 6 days (we reported to CDC and Moderna). Then he felt great for 3 days, then weird little symptoms began. Please, just put in data base to look for trends. He most likely had a very very mild case of Covid in early to mid February 2020. Lasted 3 days with fatigue and diarrhea only. Thank you very much

Other Meds: Qvar 80 mcg (Beclomethasone Dipropionate HFA) Patient died of Bacterial Endocarditis on May 6th, 2021. Could there be a vaccine

Current Illness: Absolutely none. Had been hunkered down since March 21, 2020 (that's 2020 --- twenty). We were extremely COVID careful. He might have had very mild case of Covid in early February 2020. He died of Bacterial Endocarditis on May 6, 2021. Timing just seems a bit questionable. See if you find overtime and increase of Bacterial Endocarditis post Covid vaccines, please.

ID: 1354116
Sex: F
Age: 42
State: OR

Vax Date: 05/05/2021
Onset Date: 05/10/2021
Rec V Date: 05/27/2021
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: Penicillin; Sulfa

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

Symptoms: 4-5 days after vaccination- started with chest pressure and tightness. Elevated heart rates, heart palpitations, dizziness, fatigue. Symptoms lasted 2+ weeks. Chest tightness has lessened.. Elevated heart rates remain- occasional dizziness.

Other Meds: Birth control pill

Current Illness:

ID: 1354117
Sex: M
Age: 66
State: FL

Vax Date: 04/09/2021
Onset Date: 05/02/2021
Rec V Date: 05/27/2021
Hospital: Y

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: Tremor

Symptoms: 5/2/21: Petechiae on arms, legs and inside mouth. Platelets at 1,000. Hospitalized through 5/27/21. 1st line of treatment was platelet infusion. 2nd line of treatment was IVIG. 3rd line of treatment was rixutan infusions weekly for 3 weeks. 4th line of treatment was Doptelet in increased doses for 10 days. Discharged with platelets at 20,000 and return for blood work on June 1st; follow-up with surgeon in 2 weeks to check spleen.

Other Meds: Warfarin, Keppra, B12, Calcium, Zinc, Amlodopine, Vitamin D3,

Current Illness: None

ID: 1354118
Sex: F
Age: 71
State: AL

Vax Date: 05/27/2021
Onset Date: 05/27/2021
Rec V Date: 05/27/2021
Hospital:

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

Lab Data:

Allergies: NONE

Symptom List: Erythema, Pruritus

Symptoms: Patient was given the second COVID 19 vaccine. Patient reported no problems/concerns with the first vaccine, as well as no allergies to any medications. Patient was given a 15 minute wait time after the injection. Patient was talking with staff about an upcoming flight and had some questions about COVID testing. At around the 26 minute mark patient reported some dizziness to the nurse. Vital signs were assessed and BP was 122/82, HR-64, 02- 97% RA. Patient was asked to wait a few addition minutes to reassess her vitals. Around 4 minutes later patient stood up and BP was assessed once again standing 132/84. Patient then stated she felt better and left.

Other Meds: N/A

Current Illness: N/A

ID: 1354119
Sex: F
Age: 71
State: PA

Vax Date: 02/20/2021
Onset Date: 04/05/2021
Rec V Date: 05/27/2021
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:

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

Symptoms: polymyalgia rheumatica a 71 year old female who presents for an ACUTE VISIT to review rheum consult. Had onset of both upper arms and legs. Has rotator cuff tear on L and getting MRI soon. The prednisone + tylenol bid relieves her symptoms. Pain now 1.5/10. In the am 3/10 prior to prednisone. Prior to prednisone 8/10. Pain is in muscles, gets stiff on muscles behind knees and front and back thighs and tops of calves. NOT in the joints. +stiff in the am for 2 hours. Has been holding Lipitor since 5/5/2021= 3 weeks and no change in symptoms. She is taking metamucil and walking instead to help cholesterol. No unintentional weight loss, night sweats, or unexplained fevers.

Other Meds:

Current Illness:

ID: 1354120
Sex: F
Age: 60
State: FL

Vax Date: 04/29/2021
Onset Date: 04/30/2021
Rec V Date: 05/27/2021
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: Sulfa drugs, Oxycodone, Erythromyacin

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

Symptoms: I got severe chills (tremors) first that lasted a good 10-15 minutes first. Later that day I got a fever and chills continued off and on throughout the day. I also had body aches and a headache. My left arm was also very sore. All symptoms went away on the third day except for the soreness in my arm. That lasted about four days from the time I got the shot.

Other Meds:

Current Illness: None

ID: 1354121
Sex: F
Age: 61
State: NM

Vax Date: 01/29/2021
Onset Date: 05/21/2021
Rec V Date: 05/27/2021
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: Silk tape, Motrin, Promethazine, Toradol, Augmentin and Glyburide

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Routine screening. for Covid-19. Asymptomatic. Date 2 developed shortness of breath with exertion, dry cough and afebrile. Day 5 same symptoms, plus temperature of 100 to 101.1 F

Other Meds: Alendronate, Metformin HCL, Nicotine gum, Omeprazole, Pioglitazone, Calcium, Omega-3 Fish Oil

Current Illness: Spina Bifida, Degeneration of LS intervertebral Disc, DM type 2, GERD, Obesity, Spondylolisthesis, Diabetic preipheral neuropathy, Tobacco user, Hyperlipidemia, Osteoporosis, Diverticulosis of colon

ID: 1354122
Sex: M
Age: 38
State: AR

Vax Date: 05/18/2021
Onset Date: 05/25/2021
Rec V Date: 05/27/2021
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: None known

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

Symptoms: I noticed a tingling sensation on my in my left arm that goes goes about mid way from my bicep to my hand. It is best described as when your hand falls asleep and your getting sensation back, that pins and needle feeling. When condition first occurred I figured it may have been dry skin as I just got done on 5/23/2021 working heavily in the sun and had a mild sunburn. I did not even apply skin lotion at this time. I did not notice anything unusual on 5/24/2021 as I worked hard the day before and my arms were tired. On 5/25/2021 I noticed it and it still felt like a tired arm but the tingling never left. While it is not painful or debilitating it's presence is known and is uncomfortable. I have held my arm up and performed other tests to rule out stroke. AT this time I am reporting it and will continue to monitor the situation and alert you if it gets worse or gets better.

Other Meds: men's One a day multivitamin No prescriptions

Current Illness: None

ID: 1354123
Sex: M
Age: 80
State: TX

Vax Date: 04/27/2021
Onset Date: 04/27/2021
Rec V Date: 05/27/2021
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: NKA

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

Symptoms: FIRST DOSE PATIENT WAS GIVEN PFIZER ON 3/30/21 AND SECOND DOSE PATIENT WAS GIVEN MODERNA ON 4/27/21.

Other Meds: NOT REPORTED

Current Illness: NOT REPORTED

ID: 1354124
Sex: F
Age: 70
State: CA

Vax Date: 05/27/2021
Onset Date: 05/27/2021
Rec V Date: 05/27/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Pain in extremity

Symptoms: HX BILAT MASTECTOMY, REQUESTING FOR INJECTION IN L THIGH. 2ND DOSE GIVEN IN L THIGH.

Other Meds:

Current Illness:

ID: 1354125
Sex: M
Age: 64
State: IL

Vax Date: 04/28/2021
Onset Date: 05/15/2021
Rec V Date: 05/27/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Patient is having no adverse symptoms, but the two doses were administered only 17 days apart which is outside of the standard dosing interval.

Other Meds:

Current Illness:

ID: 1354126
Sex: F
Age: 30
State: GA

Vax Date: 02/24/2021
Onset Date: 02/26/2021
Rec V Date: 05/27/2021
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: Bromfed

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

Symptoms: i developed severe migraines, and developed a huge rash on my arm at the sight of the injection. I noticed my hair falling out and thinning pout. I am not sure if it was due to having COVID in December or a reaction to the vaccine.

Other Meds: Metformin, spironolactone

Current Illness: No

ID: 1354127
Sex: F
Age: 61
State: NY

Vax Date: 04/23/2021
Onset Date: 04/30/2021
Rec V Date: 05/27/2021
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: Erythromycin

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

Symptoms: Pain in arm, feels like stabbing pain, pins and needles, stiff and hurts all the time five weeks later, I postponed the second shot

Other Meds: None

Current Illness: None

ID: 1354128
Sex: F
Age: 71
State: NV

Vax Date: 05/25/2021
Onset Date: 05/25/2021
Rec V Date: 05/27/2021
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: none

Symptom List: Vomiting

Symptoms: 6 HOURS AFTER RECEIVING THE MODERNA SHOT,JOINTS ACHE, SEVERE DIARRHEA, FEVER OF 100. LACK OF SLEEP, SEVERE HEADACHES, LACK OF ENGERY. THIS HAS NOT STOPPED SINCE ITOOK THE SHOT.

Other Meds: levxyol 75mcg, estrace cream 0.1mg, ester-c 1000mg, d-2000iu, calcium citrate 630 mg, Zinc 50 mg boron 3 mg, L-lysine 500mg. Magnesium 325mg beet root powder.

Current Illness: none

ID: 1354129
Sex: F
Age: 63
State: TX

Vax Date: 02/25/2021
Onset Date: 04/12/2021
Rec V Date: 05/27/2021
Hospital: Y

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

Lab Data:

Allergies: penicillin, keflex, sulfa, codeine, abreva

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: (04/12/21) Sudden onset of vertigo, followed by severe pain around left eye, then nausea. Treated in ER; CT/artheriogram (negative), labs, xrays, IV's, medication. Kept in hospital over night for testing and observation. Physical therapy has been ongoing to treat vertigo, dizziness.

Other Meds: Sertraline, Losartan, Buproprion, Clonazepam

Current Illness: none

ID: 1354130
Sex: F
Age: 48
State: AZ

Vax Date: 05/26/2021
Onset Date: 05/26/2021
Rec V Date: 05/27/2021
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: N/A

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

Symptoms: Initially no issue, didn't really feel the injection. It was painless, didn't feel it in the muscle which was pleasant, unlike injection #1. As the day went on the site became a painful, red lump around the injection site. I began wondering if it was injected more as a subcutaneous vs. intramuscular injection. Today the site is swollen, warm to the touch, painful, itching and red.

Other Meds: N/A

Current Illness: N/A

ID: 1354131
Sex: F
Age: 65
State: IL

Vax Date: 03/12/2021
Onset Date: 03/15/2021
Rec V Date: 05/27/2021
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: Tetracycline

Symptom List: Injection site swelling, Limb discomfort

Symptoms: About 3 days after I had the original vaccination my hair started falling out in clumps. Two days later I was completely bald on the back of my head except for a few wisps of hair on the base of my skull. I was hospitalized for breathing difficulties on 4/1/21 which was diagnosed as COPD. The breathing difficulties started after the first dose as well. I had to have my entire head shaved and now have to wear a head dressing whenever I leave the house.

Other Meds: Metoprolol, Lisinopril, Atorvastatin, Zetia, Pantoprozole, Monteleukast

Current Illness: None

ID: 1354132
Sex: M
Age: 82
State: WA

Vax Date: 03/29/2021
Onset Date: 05/22/2021
Rec V Date: 05/27/2021
Hospital: Y

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

Lab Data:

Allergies: None known

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

Symptoms: He has had vertigo non stop shortly after first dose vaccine and he's been on Meclizine with Sudafed to control the spins, he falls if doesn't take the meds. After second dose, 3/29/21 he still had the spins, but he was healthy. His wife became ill a week a go and after mothers day around 12/13 she died in her sleep on the 19/20th at night. She had been sick and did not go to the hospital. Two days later my dad came through with breakthrough covid on Saturday 5/22/2021 after receiving both vaccines. He was admitted into the hospital after testing positive for Covid. on the 26th he was moved to a skilled nursing unit for covid patients.

Other Meds: regular prescription meds and Sudafed

Current Illness: No

ID: 1354133
Sex: M
Age: 57
State: CA

Vax Date: 05/24/2021
Onset Date: 05/25/2021
Rec V Date: 05/27/2021
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: 101 fever, injection spot sore, headache, tired, feeling unwell

Other Meds: none

Current Illness: none

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm