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

Incidents per State

State Total
72,296
AK1,638
AL5,339
AR3,412
AS44
AZ13,316
CA58,147
CO11,002
CT7,824
DC1,626
DE1,670
FL36,235
FM3
GA13,429
GU82
HI2,195
IA4,332
ID2,473
IL19,261
IN22,568
KS4,284
KY6,945
LA4,714
MA13,886
MD11,901
ME2,997
MH8
MI17,865
MN11,345
MO8,919
MP30
MS2,676
MT2,147
NC15,401
ND1,273
NE2,732
NH2,859
NJ17,232
NM3,702
NV4,071
NY32,763
OH18,072
OK5,940
OR7,954
PA22,457
PR2,104
QM2
RI1,911
SC6,055
SD1,133
TN8,691
TX34,122
UT4,023
VA13,944
VI49
VT1,661
WA13,811
WI10,395
WV2,220
WY805
XB5
XL1
XV2

ID: 1552673
Sex: M
Age: 74
State: NJ

Vax Date: 01/28/2021
Onset Date: 01/29/2021
Rec V Date: 08/13/2021
Hospital:

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Symptom List:

Symptoms: This spontaneous case was reported by a consumer and describes the occurrence of BALANCE DISORDER (equilibrium was off), SOMNOLENCE (slept for 24hs), DECREASED APPETITE (did not have appetite), ARTHRALGIA (joint pain) and PYREXIA (fever of 100?F) in a 74-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 030L20A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. The patient's past medical history included COVID-19 on 17-Mar-2021. On 28-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 29-Jan-2021, the patient experienced BALANCE DISORDER (equilibrium was off), SOMNOLENCE (slept for 24hs), DECREASED APPETITE (did not have appetite), ARTHRALGIA (joint pain), PYREXIA (fever of 100?F) and CHILLS (chills). On 31-Jan-2021, BALANCE DISORDER (equilibrium was off), SOMNOLENCE (slept for 24hs), DECREASED APPETITE (did not have appetite), ARTHRALGIA (joint pain), PYREXIA (fever of 100?F) and CHILLS (chills) had resolved. Not Provided DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 29-Jan-2021, Body temperature: 100?f High. 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. Concomitant product use was unknown by the reporter. Treatment medication included ibuprofen Most recent FOLLOW-UP information incorporated above includes: On 05-May-2021: Follow-up information received on 05 May 2021n contain PCP removed as primary reporter.; Sender's Comments: MOD-2021-019789:Same reporter/different patient (wife). PCP is not a valid reporter or husband.

Other Meds:

Current Illness:

ID: 1552674
Sex: F
Age: 75
State: LA

Vax Date: 01/30/2021
Onset Date:
Rec V Date: 08/13/2021
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Symptom List:

Symptoms: rash itches; sore arm; scarlett red rash down both arms,entire trunk of body, and both legs; chills; This spontaneous case was reported by a consumer and describes the occurrence of RASH PRURITIC (rash itches), PAIN IN EXTREMITY (sore arm), RASH (scarlett red rash down both arms,entire trunk of body, and both legs) and CHILLS (chills) in a 75-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 032L20A) for COVID-19 vaccination. The patient's past medical history included No adverse event (no medical history was reported). On 30-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On an unknown date, the patient experienced RASH PRURITIC (rash itches), PAIN IN EXTREMITY (sore arm), RASH (scarlett red rash down both arms,entire trunk of body, and both legs) and CHILLS (chills). At the time of the report, RASH PRURITIC (rash itches), PAIN IN EXTREMITY (sore arm), RASH (scarlett red rash down both arms,entire trunk of body, and both legs) and CHILLS (chills) had not resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Concomitant product use was not provided by the reporter. No treatment information was provided.

Other Meds:

Current Illness:

ID: 1552675
Sex: F
Age:
State: MI

Vax Date:
Onset Date: 02/17/2021
Rec V Date: 08/13/2021
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Vax Type:
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Symptom List:

Symptoms: Itchiness which is spreading; Redness which is spreading; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE PRURITUS (Itchiness which is spreading) and VACCINATION SITE ERYTHEMA (Redness which is spreading) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The patient's past medical history included No adverse event (no historical condition was reported). On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 17-Feb-2021, the patient experienced VACCINATION SITE PRURITUS (Itchiness which is spreading) and VACCINATION SITE ERYTHEMA (Redness which is spreading). At the time of the report, VACCINATION SITE PRURITUS (Itchiness which is spreading) and VACCINATION SITE ERYTHEMA (Redness which is spreading) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown.

Other Meds:

Current Illness:

ID: 1552676
Sex: F
Age: 79
State: MD

Vax Date: 02/04/2021
Onset Date: 02/05/2021
Rec V Date: 08/13/2021
Hospital:

Vax Type:
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Symptom List:

Symptoms: left breast pain; This spontaneous case was reported by a consumer and describes the occurrence of BREAST PAIN (left breast pain) in a 79-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The patient's past medical history included No adverse event (no historical condition was reported). Concurrent medical conditions included Hypertension. Concomitant products included VITAMINS NOS for an unknown indication. On 04-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 05-Feb-2021, the patient experienced BREAST PAIN (left breast pain). At the time of the report, BREAST PAIN (left breast pain) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Concomitant medication included High Blood Pressure medication, acid reflux medication, Cranberry supplement and Cinnamon supplement. Treatment medication were not provided/unknown.

Other Meds: VITAMINS NOS

Current Illness:

ID: 1552677
Sex: M
Age:
State: OH

Vax Date: 02/01/2021
Onset Date: 02/01/2021
Rec V Date: 08/13/2021
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Symptoms: mild case of nausea; This spontaneous case was reported by a nurse and describes the occurrence of NAUSEA (mild case of 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 No adverse event (No medical history reported). On 01-Feb-2021, the patient 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 received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 01-Feb-2021, the patient experienced NAUSEA (mild case of nausea). On 02-Feb-2021, NAUSEA (mild case of nausea) had resolved. Not Provided For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments.

Other Meds:

Current Illness:

ID: 1552678
Sex: F
Age: 69
State: GA

Vax Date: 01/19/2021
Onset Date: 01/20/2021
Rec V Date: 08/13/2021
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Vax Type:
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Symptom List:

Symptoms: vaccination site rash; A spontaneous report was received from a consumer concerning a 69-years-old patient who received Moderna's COVID-19 vaccine (mRNA-1273) and experienced event vaccination site rash. The patient's medical history was not provided. Current condition include lupus. No relevant concomitant medications were reported. On 19 Jan 2021, prior to the onset of the events the patient received their first of two planned doses of mRNA-1273 (lot/batch: 028L20A) in the right arm for prophylaxis of COVID-19 infection. On 20 Jan 2021, the patient experienced the event rashes which started on her right arm and by the end of the day have spread out to her trunk. Treatment details included Benadryl. The rashes resolved in one and a half days. Action taken with mRNA-1273 in response to the events was unknown. The outcome of event, rashes was resolved on 21 Jan 2021.; Reporter'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: Lupus erythematosus (current condition include Lupus)

ID: 1552679
Sex: F
Age: 36
State: NJ

Vax Date: 01/13/2021
Onset Date: 01/24/2021
Rec V Date: 08/13/2021
Hospital:

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Symptom List:

Symptoms: Itchiness at the injection site; She started experiencing Hives at injection site; Redness at injection site; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE PRURITUS (Itchiness at the injection site), VACCINATION SITE URTICARIA (She started experiencing Hives at injection site) and VACCINATION SITE ERYTHEMA (Redness at injection site) in a 36-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 012L20A) for COVID-19 vaccination. The patient's past medical history included No adverse event (no historical condition was reported). On 13-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 24-Jan-2021, the patient experienced VACCINATION SITE PRURITUS (Itchiness at the injection site), VACCINATION SITE URTICARIA (She started experiencing Hives at injection site) and VACCINATION SITE ERYTHEMA (Redness at injection site). At the time of the report, VACCINATION SITE PRURITUS (Itchiness at the injection site), VACCINATION SITE URTICARIA (She started experiencing Hives at injection site) and VACCINATION SITE ERYTHEMA (Redness at injection site) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown.

Other Meds:

Current Illness:

ID: 1552680
Sex: M
Age: 66
State: WI

Vax Date: 01/22/2021
Onset Date: 01/22/2021
Rec V Date: 08/13/2021
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Vax Type:
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Symptom List:

Symptoms: Red and puffy; Red spot; Sore arm; This spontaneous case was reported by a physician and describes the occurrence of VACCINATION SITE PAIN (Sore arm), VACCINATION SITE SWELLING (Red and puffy) and VACCINATION SITE ERYTHEMA (Red spot) in a 66-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 013L20A) for COVID-19 vaccination. The patient's past medical history included No adverse event (no medical history was reported). Concomitant products included PARACETAMOL (TYLENOL), OXYCODONE HYDROCHLORIDE (OXICODONE ACCORD), TRAMADOL and DIPHENHYDRAMINE HYDROCHLORIDE (BENADRYL [DIPHENHYDRAMINE HYDROCHLORIDE]) for an unknown indication. On 22-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 22-Jan-2021, the patient experienced VACCINATION SITE PAIN (Sore arm). On 03-Feb-2021, the patient experienced VACCINATION SITE SWELLING (Red and puffy) and VACCINATION SITE ERYTHEMA (Red spot). On 27-Jan-2021, VACCINATION SITE PAIN (Sore arm) had resolved. At the time of the report, VACCINATION SITE SWELLING (Red and puffy) and VACCINATION SITE ERYTHEMA (Red spot) 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.

Other Meds: TYLENOL; OXICODONE ACCORD; TRAMADOL; BENADRYL [DIPHENHYDRAMINE HYDROCHLORIDE]

Current Illness:

ID: 1552681
Sex: F
Age: 41
State: TX

Vax Date: 02/01/2021
Onset Date: 02/01/2021
Rec V Date: 08/13/2021
Hospital:

Vax Type:
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Symptom List:

Symptoms: lump about the size of the baseball under the armpit/ arm where she received the vaccine; chills; fever; This spontaneous case was reported by a consumer and describes the occurrence of AXILLARY MASS (lump about the size of the baseball under the armpit/ arm where she received the vaccine), CHILLS (chills) and PYREXIA (fever) in a 41-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. Concomitant products included METFORMIN and LORAZEPAM (ATIVAN) for an unknown indication. On 01-Feb-2021, the patient 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 received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 01-Feb-2021, the patient experienced AXILLARY MASS (lump about the size of the baseball under the armpit/ arm where she received the vaccine), CHILLS (chills) and PYREXIA (fever). The patient was treated with PARACETAMOL (TYLENOL) for Fever, at a dose of 1 dosage form. At the time of the report, AXILLARY MASS (lump about the size of the baseball under the armpit/ arm where she received the vaccine), CHILLS (chills) and PYREXIA (fever) outcome was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. Action taken with mRNA-1273 in response to the drug was not applicable.; 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: METFORMIN; ATIVAN

Current Illness:

ID: 1552682
Sex: M
Age:
State: CA

Vax Date: 01/28/2021
Onset Date: 01/29/2021
Rec V Date: 08/13/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
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Symptom List:

Symptoms: weak; peeing himself; dizzy; fever; This spontaneous case was reported by a consumer and describes the occurrence of ASTHENIA (weak), URINARY INCONTINENCE (peeing himself), DIZZINESS (dizzy) and PYREXIA (fever) in a 69-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 041L20A) for COVID-19 vaccination. The patient's past medical history included No adverse event (no historical condition was reported). Concomitant products included VITAMIN D2, ACETYLSALICYLIC ACID (ASPIRIN EC), CARVEDILOL, CALCITRIOL, GABAPENTIN, ALLOPURINOL, AMLODIPINE, CITALOPRAM and ATORVASTATIN 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 29-Jan-2021, the patient experienced ASTHENIA (weak), URINARY INCONTINENCE (peeing himself), DIZZINESS (dizzy) and PYREXIA (fever). At the time of the report, ASTHENIA (weak), URINARY INCONTINENCE (peeing himself), DIZZINESS (dizzy) and PYREXIA (fever) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown.

Other Meds: VITAMIN D2; ASPIRIN EC; CARVEDILOL; CALCITRIOL; GABAPENTIN; ALLOPURINOL; AMLODIPINE; CITALOPRAM; ATORVASTATIN

Current Illness:

ID: 1552683
Sex: F
Age: 78
State: GA

Vax Date: 02/16/2021
Onset Date: 02/16/2021
Rec V Date: 08/13/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
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Lab Data:

Allergies:

Symptom List:

Symptoms: just wasn't with it; arm was sore; she begun to have the chills this morning and every part of her body was cold; headache; This spontaneous case was reported by a consumer and describes the occurrence of FEELING ABNORMAL (just wasn't with it), CHILLS (she begun to have the chills this morning and every part of her body was cold), HEADACHE (headache) and VACCINATION SITE PAIN (arm was sore) in a 79-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 026620A and 027620A) for COVID-19 vaccination. The patient's past medical history included No adverse event (no medical history reported). On 16-Feb-2021, the patient 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 received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 16-Feb-2021, the patient experienced CHILLS (she begun to have the chills this morning and every part of her body was cold) and HEADACHE (headache). On an unknown date, the patient experienced FEELING ABNORMAL (just wasn't with it) and VACCINATION SITE PAIN (arm was sore). At the time of the report, FEELING ABNORMAL (just wasn't with it), CHILLS (she begun to have the chills this morning and every part of her body was cold), HEADACHE (headache) and VACCINATION SITE PAIN (arm was sore) outcome was unknown. No concomitants or treatment medications were reported.

Other Meds:

Current Illness:

ID: 1552684
Sex: F
Age:
State: CA

Vax Date: 01/28/2021
Onset Date:
Rec V Date: 08/13/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List:

Symptoms: Got very, very ill; Weakness to where it was hard to get out of bed; Trouble breathing; Fever of 103 F; Nausea; Headache; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION COMPLICATION (Got very, very ill), ASTHENIA (Weakness to where it was hard to get out of bed), DYSPNOEA (Trouble breathing), PYREXIA (Fever of 103 F) and NAUSEA (Nausea) in an 84-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. The patient's past medical history included No adverse event (no medical history was reported). On 28-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On an unknown date, the patient experienced VACCINATION COMPLICATION (Got very, very ill), ASTHENIA (Weakness to where it was hard to get out of bed), DYSPNOEA (Trouble breathing), PYREXIA (Fever of 103 F), NAUSEA (Nausea) and HEADACHE (Headache). At the time of the report, VACCINATION COMPLICATION (Got very, very ill), ASTHENIA (Weakness to where it was hard to get out of bed), DYSPNOEA (Trouble breathing), PYREXIA (Fever of 103 F), NAUSEA (Nausea) and HEADACHE (Headache) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown.

Other Meds:

Current Illness:

ID: 1552685
Sex: F
Age: 70
State: MD

Vax Date: 02/03/2021
Onset Date: 02/04/2021
Rec V Date: 08/13/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List:

Symptoms: Severe pain on injection arm; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE PAIN (Severe pain on injection arm) in a 70-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 00M00A) for COVID-19 vaccination. The patient's past medical history included No adverse event (No adverse event history). On 03-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 04-Feb-2021, the patient experienced VACCINATION SITE PAIN (Severe pain on injection arm). At the time of the report, VACCINATION SITE PAIN (Severe pain on injection arm) 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.

Other Meds:

Current Illness:

ID: 1552686
Sex: F
Age: 70
State: GA

Vax Date: 01/18/2021
Onset Date: 01/29/2021
Rec V Date: 08/13/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List:

Symptoms: Itching near injection site; Rash near injection site; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE PRURITUS (Itching near injection site) and VACCINATION SITE RASH (Rash near injection site) in a 70-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The patient's past medical history included No adverse event (No adverse event history). Concomitant products included LISINOPRIL, ZINC, ASCORBIC ACID, ROSA CANINA FRUIT (VITAMIN C & ROSEHIP) and ATORVASTATIN CALCIUM (LIPITOR) for an unknown indication. On 18-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 29-Jan-2021, the patient experienced VACCINATION SITE PRURITUS (Itching near injection site) and VACCINATION SITE RASH (Rash near injection site). At the time of the report, VACCINATION SITE PRURITUS (Itching near injection site) had resolved and VACCINATION SITE RASH (Rash near injection site) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown.

Other Meds: LISINOPRIL; ZINC; VITAMIN C & ROSEHIP; LIPITOR

Current Illness:

ID: 1552687
Sex: F
Age: 20
State: FL

Vax Date: 02/04/2021
Onset Date: 02/04/2021
Rec V Date: 08/13/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
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Vax Site:

Lab Data:

Allergies:

Symptom List:

Symptoms: Really tired; Pain on the injection site; Swelling on the injection site; This spontaneous case was reported by an other health care professional and describes the occurrence of VACCINATION SITE PAIN (Pain on the injection site), VACCINATION SITE SWELLING (Swelling on the injection site) and FATIGUE (Really tired) in a 20-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 031L20A) for COVID-19 vaccination. The patient's past medical history included No adverse event (no historical condition was reported). On 04-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 04-Feb-2021, the patient experienced VACCINATION SITE PAIN (Pain on the injection site) and VACCINATION SITE SWELLING (Swelling on the injection site). On an unknown date, the patient experienced FATIGUE (Really tired). At the time of the report, VACCINATION SITE PAIN (Pain on the injection site), VACCINATION SITE SWELLING (Swelling on the injection site) and FATIGUE (Really tired) 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.

Other Meds:

Current Illness:

ID: 1552688
Sex: F
Age:
State: MD

Vax Date: 02/04/2021
Onset Date: 02/04/2021
Rec V Date: 08/13/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List:

Symptoms: Feeling was just odd; Feeling Jittery; Different taste in my mouth; Dryness in my mouth; Light headedness; This spontaneous case was reported by a consumer and describes the occurrence of FEELING ABNORMAL (Feeling was just odd), FEELING JITTERY (Feeling Jittery), TASTE DISORDER (Different taste in my mouth), DRY MOUTH (Dryness in my mouth) and DIZZINESS (Light headedness) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The patient's past medical history included No adverse event (No medical history was reported). On 04-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 04-Feb-2021, the patient experienced FEELING ABNORMAL (Feeling was just odd), FEELING JITTERY (Feeling Jittery), TASTE DISORDER (Different taste in my mouth) and DRY MOUTH (Dryness in my mouth). On an unknown date, the patient experienced DIZZINESS (Light headedness). At the time of the report, FEELING ABNORMAL (Feeling was just odd), FEELING JITTERY (Feeling Jittery), TASTE DISORDER (Different taste in my mouth), DRY MOUTH (Dryness in my mouth) and DIZZINESS (Light headedness) had resolved. 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.

Other Meds:

Current Illness:

ID: 1552689
Sex: F
Age: 73
State: AL

Vax Date: 01/18/2021
Onset Date: 01/18/2021
Rec V Date: 08/13/2021
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Symptom List:

Symptoms: had a sore arm; woke up and was about to fall on the floor; had a mini nerve attack; A spontaneous report was received from a consumer concerning a 73-year-old, female patient, who received Moderna's COVID-19 vaccine (mRNA-1273) and experienced woke up and was about to fall on the floor, had a mini nerve attack, and sore arm. The patient's medical history, was not provided by the reporter. Concomitant medications were not reported. On 18 Jan 2021, approximately same day prior to the onset of the events, the patient received the first of two planned doses of mRNA-1273 (Lot number: unknown) intramuscularly in the right arm for prophylaxis of COVID-19 infection. On 18 Jan 2021, after receiving mRNA-1273, the patient woke up in the middle of that night experiencing "mini nerve attack". The patient stated "was about to fall on the floor but didn't and sat back down" on bed and was able to go back to sleep. The patient woke up again and was given two Tylenols by the nurse. At 0700am, the patient wasn't feeling normal and had a sore arm. Patient was then given Norco to relieve the pain. Treatment for the events included acetaminophen, Narco was reported. Action taken with mRNA-1273 in response to the events was not reported. The events, woke up and was about to fall on the floor, had a mini nerve attack, and sore arm were considered resolved on an unknown date.; Reporter's Comments: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.

Other Meds:

Current Illness:

ID: 1552690
Sex: F
Age: 44
State: MA

Vax Date: 01/04/2021
Onset Date: 02/01/2021
Rec V Date: 08/13/2021
Hospital:

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Symptom List:

Symptoms: This spontaneous case was reported by a consumer and describes the occurrence of INJECTION SITE PAIN (sore arm at the injection site that resolved), INJECTION SITE PAIN (sore arm at the injection site), CHILLS (chills), NAUSEA (nausea) and HEADACHE (mild headache) in a 44-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The patient's past medical history included No adverse event (No historical condition was reported). On 04-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 01-Feb-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 01-Feb-2021, the patient experienced INJECTION SITE PAIN (sore arm at the injection site that resolved), INJECTION SITE PAIN (sore arm at the injection site), CHILLS (chills), NAUSEA (nausea) and HEADACHE (mild headache). On 02-Feb-2021, INJECTION SITE PAIN (sore arm at the injection site that resolved), INJECTION SITE PAIN (sore arm at the injection site), CHILLS (chills) and NAUSEA (nausea) had resolved. At the time of the report, HEADACHE (mild headache) outcome was unknown.

Other Meds:

Current Illness:

ID: 1552691
Sex: M
Age:
State: CA

Vax Date: 01/28/2021
Onset Date:
Rec V Date: 08/13/2021
Hospital:

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Symptoms: Fever of 102F; Headache; This spontaneous case was reported by a consumer and describes the occurrence of PYREXIA (Fever of 102F) and HEADACHE (Headache) in an 82-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 042L20A) for COVID-19 vaccination. The patient's past medical history included COVID-19 in December 2020. On 28-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On an unknown date, the patient experienced PYREXIA (Fever of 102F) and HEADACHE (Headache). At the time of the report, PYREXIA (Fever of 102F) and HEADACHE (Headache) had resolved. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, Body temperature: 102F. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown.

Other Meds:

Current Illness:

ID: 1552692
Sex: M
Age: 34
State: NY

Vax Date: 02/03/2021
Onset Date: 02/04/2021
Rec V Date: 08/13/2021
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Symptoms: This spontaneous case was reported by a consumer and describes the occurrence of PYREXIA (fever), CHILLS (Chills), NAUSEA (nausea) and HEADACHE (headache) in a 34-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 013620A) for COVID-19 vaccination. The patient's past medical history included No adverse event (no historical condition was reported). On 03-Feb-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) (Intramuscular) 1 dosage form. On 04-Feb-2021, the patient experienced PYREXIA (fever), CHILLS (Chills), NAUSEA (nausea) and HEADACHE (headache). At the time of the report, PYREXIA (fever), CHILLS (Chills), NAUSEA (nausea) and HEADACHE (headache) outcome was unknown.

Other Meds:

Current Illness:

ID: 1552693
Sex: F
Age:
State: WA

Vax Date:
Onset Date: 01/31/2021
Rec V Date: 08/13/2021
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Symptoms: Red Spots (Injection Site); Swollen; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE RASH (Red Spots (Injection Site)) and VACCINATION SITE SWELLING (Swollen) in a 71-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 042L20A) for COVID-19 vaccination. The patient's past medical history included No adverse event (no historical condition was reported). On 18-Jan-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 first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 31-Jan-2021, the patient experienced VACCINATION SITE RASH (Red Spots (Injection Site)) and VACCINATION SITE SWELLING (Swollen). At the time of the report, VACCINATION SITE RASH (Red Spots (Injection Site)) and VACCINATION SITE SWELLING (Swollen) outcome was unknown. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. This case was linked to US-MODERNATX, INC.-MOD-2021-063831 (E2B Linked Report).

Other Meds:

Current Illness:

ID: 1552694
Sex: M
Age: 94
State: OH

Vax Date: 02/04/2021
Onset Date: 02/04/2021
Rec V Date: 08/13/2021
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Symptoms: Extreme shakiness; was unable to walk well; vomiting; pain injection site/soreness around injection site; This spontaneous case was reported by a consumer and describes the occurrence of TREMOR (Extreme shakiness), GAIT INABILITY (was unable to walk well), VOMITING (vomiting) and VACCINATION SITE PAIN (pain injection site/soreness around injection site) in a 94-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The patient's past medical history included No adverse event (No medical history reported). On 04-Feb-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) (Intramuscular) 1 dosage form. On 04-Feb-2021, the patient experienced VACCINATION SITE PAIN (pain injection site/soreness around injection site). On 05-Feb-2021, the patient experienced TREMOR (Extreme shakiness), GAIT INABILITY (was unable to walk well) and VOMITING (vomiting). At the time of the report, TREMOR (Extreme shakiness), GAIT INABILITY (was unable to walk well), VOMITING (vomiting) and VACCINATION SITE PAIN (pain injection site/soreness around injection site) outcome was unknown.

Other Meds:

Current Illness:

ID: 1552695
Sex: F
Age:
State:

Vax Date: 02/11/2021
Onset Date: 02/16/2021
Rec V Date: 08/13/2021
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Symptoms: it's going down the inside of the arm now; it started to itch in that area; This spontaneous case was reported by a consumer and describes the occurrence of PRURITUS (it's going down the inside of the arm now) and VACCINATION SITE PRURITUS (it started to itch in that area) 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 11-Feb-2021, the patient 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 received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 16-Feb-2021, the patient experienced PRURITUS (it's going down the inside of the arm now) and VACCINATION SITE PRURITUS (it started to itch in that area). At the time of the report, PRURITUS (it's going down the inside of the arm now) and VACCINATION SITE PRURITUS (it started to itch in that area) outcome was unknown. Treatment and concomitant medications were not reported. Action taken in response to mRNA-1273 was not applicable. Most recent FOLLOW-UP information incorporated above includes: On 17-Feb-2021: process with initial

Other Meds:

Current Illness:

ID: 1552696
Sex: F
Age: 25
State:

Vax Date: 01/08/2021
Onset Date: 01/08/2021
Rec V Date: 08/13/2021
Hospital:

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Symptoms: Experienced flu like symptoms; This spontaneous case was reported by a consumer and describes the occurrence of INFLUENZA LIKE ILLNESS (Experienced flu like symptoms) in a 25-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 025J20-A) for COVID-19 vaccination. The patient's past medical history included No adverse event (No historical condition was reported). On 08-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 08-Jan-2021, the patient experienced INFLUENZA LIKE ILLNESS (Experienced flu like symptoms). At the time of the report, INFLUENZA LIKE ILLNESS (Experienced flu like symptoms) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitants or treatment medications were reported.

Other Meds:

Current Illness:

ID: 1552697
Sex: F
Age:
State: NM

Vax Date: 01/07/2021
Onset Date: 01/07/2021
Rec V Date: 08/13/2021
Hospital:

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Symptoms: Little sore at injection site; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE PAIN (Little sore at injection site) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 025A202A) for COVID-19 vaccination. The patient's past medical history included Chemotherapy. On 07-Jan-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 07-Jan-2021, the patient experienced VACCINATION SITE PAIN (Little sore at injection site). At the time of the report, VACCINATION SITE PAIN (Little sore at injection site) outcome was unknown. Not Provided mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosing remained unchanged. Concomitant products included Blood Pressure and Cholesterol medications. No corrective treatment was provided. Most recent FOLLOW-UP information incorporated above includes: On 20-Apr-2021: Added second dosage regimen.

Other Meds:

Current Illness:

ID: 1552698
Sex: M
Age:
State: CA

Vax Date: 01/28/2021
Onset Date:
Rec V Date: 08/13/2021
Hospital:

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Symptoms: SORE ARM; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE PAIN (SORE ARM) in an 83-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The patient's past medical history included No adverse event (no historical condition was reported). On 28-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On an unknown date, the patient experienced VACCINATION SITE PAIN (SORE ARM). At the time of the report, VACCINATION SITE PAIN (SORE ARM) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown.

Other Meds:

Current Illness:

ID: 1552699
Sex: M
Age: 78
State: CA

Vax Date: 02/03/2021
Onset Date: 02/03/2021
Rec V Date: 08/13/2021
Hospital:

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Symptoms: can not get out of bed; muscle pain; Headache; sore arm; This spontaneous case was reported by a consumer and describes the occurrence of BEDRIDDEN (can not get out of bed), MYALGIA (muscle pain), HEADACHE (Headache) and VACCINATION SITE PAIN (sore arm) in a 78-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for an unknown indication. The patient's past medical history included COVID-19 on 13-Jan-2021. On 03-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 03-Feb-2021, the patient experienced BEDRIDDEN (can not get out of bed), MYALGIA (muscle pain), HEADACHE (Headache) and VACCINATION SITE PAIN (sore arm). At the time of the report, BEDRIDDEN (can not get out of bed), MYALGIA (muscle pain), HEADACHE (Headache) and VACCINATION SITE PAIN (sore arm) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown.

Other Meds:

Current Illness:

ID: 1552700
Sex: F
Age: 79
State: TX

Vax Date: 01/27/2021
Onset Date: 02/04/2021
Rec V Date: 08/13/2021
Hospital:

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Symptoms: Pink around the injection site; It itches; Patient's injection site became raised and swollen, the size of a lemon; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE DISCOLOURATION (Pink around the injection site), VACCINATION SITE PRURITUS (It itches) and VACCINATION SITE SWELLING (Patient's injection site became raised and swollen, the size of a lemon) in a 79-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 010M20A) for COVID-19 vaccination. The patient's past medical history included No adverse event (no medical history was reported). On 27-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 04-Feb-2021, the patient experienced VACCINATION SITE PRURITUS (It itches) and VACCINATION SITE SWELLING (Patient's injection site became raised and swollen, the size of a lemon). On an unknown date, the patient experienced VACCINATION SITE DISCOLOURATION (Pink around the injection site). At the time of the report, VACCINATION SITE DISCOLOURATION (Pink around the injection site), VACCINATION SITE PRURITUS (It itches) and VACCINATION SITE SWELLING (Patient's injection site became raised and swollen, the size of a lemon) outcome was unknown. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown.

Other Meds:

Current Illness:

ID: 1552701
Sex: F
Age: 71
State: FL

Vax Date: 01/27/2021
Onset Date: 01/27/2021
Rec V Date: 08/13/2021
Hospital:

Vax Type:
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Symptom List:

Symptoms: sugar levels went very low; itchiness on injection site; Swollen arm; This spontaneous case was reported by a consumer and describes the occurrence of PERIPHERAL SWELLING (Swollen arm), BLOOD GLUCOSE DECREASED (sugar levels went very low) and VACCINATION SITE PRURITUS (itchiness on injection site) in a 71-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. D13L20A) for COVID-19 vaccination. No medical history was provided by the reporter. On 27-Jan-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 27-Jan-2021, the patient experienced PERIPHERAL SWELLING (Swollen arm) and VACCINATION SITE PRURITUS (itchiness on injection site). On an unknown date, the patient experienced BLOOD GLUCOSE DECREASED (sugar levels went very low). At the time of the report, PERIPHERAL SWELLING (Swollen arm), BLOOD GLUCOSE DECREASED (sugar levels went very low) and VACCINATION SITE PRURITUS (itchiness on injection site) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, Blood glucose: low (Low) Low. 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. Most recent FOLLOW-UP information incorporated above includes: On 17-Apr-2021: Added a new event (blood glucose decreased).; 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: 1552702
Sex: F
Age: 85
State: NC

Vax Date: 01/21/2021
Onset Date: 01/21/2021
Rec V Date: 08/13/2021
Hospital:

Vax Type:
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Symptom List:

Symptoms: Skin feels warm; Skin feels hard; Skin itching; Red rash on site of administration; A spontaneous report was received from a consumer concerning herself a 85? years-old female patient who received Moderna's COVID-19 vaccine (mRNA-1273) and experienced red rash on site of administration/vaccination site rash, skin itching/vaccination site pruritus, skin feels warm/vaccination site warmth and skin feels hard/vaccination site induration. The patient's medical history was not provided. No relevant concomitant medications were reported. On 21 Jan 2021, prior to the onset of the events, the patient received their first of two planned doses of mRNA-1273 (lot/batch unknown) intramuscularly for prophylaxis of COVID-19 infection. On 21 Jan 2021, the patient experienced red rash on site of administration and skin itching. She also says that her skin feels warm and hard. No treatment information was provided. Action taken with mRNA-1273 in response to the events was not reported. The outcome of the events, red rash on site of administration, skin itching, skin feels warm and skin feels hard were unknown.

Other Meds:

Current Illness:

ID: 1552703
Sex: M
Age: 80
State: IA

Vax Date: 01/22/2021
Onset Date: 01/30/2021
Rec V Date: 08/13/2021
Hospital:

Vax Type:
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Symptom List:

Symptoms: Missed second dose; Itching; big rash on his chest/got a horrible rash all over their entire body; This spontaneous case was reported by a consumer and describes the occurrence of PRURITUS (Itching), RASH (big rash on his chest/got a horrible rash all over their entire body) and PRODUCT DOSE OMISSION ISSUE (Missed second dose) in an 81-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 22-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 30-Jan-2021, the patient experienced PRURITUS (Itching) and RASH (big rash on his chest/got a horrible rash all over their entire body). On an unknown date, the patient experienced PRODUCT DOSE OMISSION ISSUE (Missed second dose). The patient was treated with PREDNISONE (oral) for Rash and Itching, at an unspecified dose and frequency. At the time of the report, PRURITUS (Itching) outcome was unknown, RASH (big rash on his chest/got a horrible rash all over their entire body) had not resolved and PRODUCT DOSE OMISSION ISSUE (Missed second dose) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Treatment included injectable steroids. No concomitant medication was provided. On an unknown date, Biopsy and Throat culture was performed, but result was not available. Most recent FOLLOW-UP information incorporated above includes: On 21-Apr-2021: Updated event - Product dose omission issue.

Other Meds:

Current Illness:

ID: 1552704
Sex: F
Age: 43
State: VA

Vax Date: 01/28/2021
Onset Date: 02/17/2021
Rec V Date: 08/13/2021
Hospital:

Vax Type:
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Vax Name:
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Lab Data:

Allergies:

Symptom List:

Symptoms: Anxiety; Panic attack; Confusion; Unusual sensations on the brain; Problems to concentrate; This spontaneous case was reported by an other health care professional and describes the occurrence of ANXIETY (Anxiety), PANIC ATTACK (Panic attack), CONFUSIONAL STATE (Confusion), FEELING ABNORMAL (Unusual sensations on the brain) and DISTURBANCE IN ATTENTION (Problems to concentrate) in a 43-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 013L20A) for COVID-19 vaccination. No medical history was provided by the reporter. On 28-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 17-Feb-2021, the patient experienced ANXIETY (Anxiety), PANIC ATTACK (Panic attack), CONFUSIONAL STATE (Confusion), FEELING ABNORMAL (Unusual sensations on the brain) and DISTURBANCE IN ATTENTION (Problems to concentrate). At the time of the report, ANXIETY (Anxiety), PANIC ATTACK (Panic attack), CONFUSIONAL STATE (Confusion), FEELING ABNORMAL (Unusual sensations on the brain) and DISTURBANCE IN ATTENTION (Problems to concentrate) 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.; Sender's Comments: Very limited information regarding this events has been provided at this time. Further information has been requested. Company assessed the events to be unlikely related to company product.

Other Meds:

Current Illness:

ID: 1552705
Sex: F
Age: 77
State: MI

Vax Date: 03/05/2021
Onset Date: 03/08/2021
Rec V Date: 08/13/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
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Lab Data:

Allergies:

Symptom List:

Symptoms: In lot of pain; Shoulder blade pain; Back pain; Left arm extremely sore; This spontaneous case was reported by a consumer and describes the occurrence of BACK PAIN (Back pain), PAIN IN EXTREMITY (Left arm extremely sore), PAIN (In lot of pain) and ARTHRALGIA (Shoulder blade pain) in a 77-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 030A21A) for COVID-19 vaccination. The patient's past medical history included Lung cancer and Cancer surgery (Lung cancer surgery). Concomitant products included AMLODIPINE, HYDROCHLOROTHIAZIDE and ATORVASTATIN for an unknown indication. On 05-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 08-Mar-2021, the patient experienced BACK PAIN (Back pain), PAIN IN EXTREMITY (Left arm extremely sore) and ARTHRALGIA (Shoulder blade pain). On an unknown date, the patient experienced PAIN (In lot of pain). The patient was treated with PARACETAMOL (TYLENOL) for Pain, at an unspecified dose and frequency and ACETYLSALICYLIC ACID (ASPRIN) for Pain, at an unspecified dose and frequency. At the time of the report, BACK PAIN (Back pain), PAIN IN EXTREMITY (Left arm extremely sore), PAIN (In lot of pain) and ARTHRALGIA (Shoulder blade pain) had not resolved. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. patient is on radiation therapy Radiation therapy. Most recent FOLLOW-UP information incorporated above includes: On 05-May-2021: Added current condition (Radiation). New event (In lot of pain) added. On 21-May-2021: Follow-up information received on 21-MAY-2021 contains non-significant information ("The patient reported that the reaction had nothing to do with the vaccine").

Other Meds: AMLODIPINE; HYDROCHLOROTHIAZIDE; ATORVASTATIN

Current Illness:

ID: 1552706
Sex: F
Age: 26
State: IL

Vax Date: 01/18/2021
Onset Date: 01/31/2021
Rec V Date: 08/13/2021
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Symptoms: patient was breastfeeding; developed a runny nose; Felt cold; Body aches; had chills; Tired; Headache / headache was pretty bad; This spontaneous case was reported by a nurse and describes the occurrence of RHINORRHOEA (developed a runny nose), NASOPHARYNGITIS (Felt cold), EXPOSURE VIA BREAST MILK (patient was breastfeeding), MYALGIA (Body aches) and CHILLS (had chills) in a 26-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 01320A) for COVID-19 immunisation. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 18-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 31-Jan-2021, the patient experienced NASOPHARYNGITIS (Felt cold), MYALGIA (Body aches), CHILLS (had chills), FATIGUE (Tired) and HEADACHE (Headache / headache was pretty bad). On 02-Feb-2021, the patient experienced RHINORRHOEA (developed a runny nose). On an unknown date, the patient experienced EXPOSURE VIA BREAST MILK (patient was breastfeeding). The patient was treated with PARACETAMOL (TYLENOL) at an unspecified dose and frequency and IBUPROFEN (MOTRIN [IBUPROFEN]) at an unspecified dose and frequency. On 03-Feb-2021, RHINORRHOEA (developed a runny nose), NASOPHARYNGITIS (Felt cold), MYALGIA (Body aches), CHILLS (had chills) and FATIGUE (Tired) had resolved. On 04-Feb-2021, HEADACHE (Headache / headache was pretty bad) had resolved. At the time of the report, EXPOSURE VIA BREAST MILK (patient was breastfeeding) had resolved. 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. No concomitant medications were reported.

Other Meds:

Current Illness:

ID: 1552707
Sex: M
Age: 69
State: VA

Vax Date: 01/29/2021
Onset Date: 01/30/2021
Rec V Date: 08/13/2021
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Symptoms: Deterioration to the point that he cannot hold a fork or tie his shoelaces; he also cannot go to the bathroom on his own; This spontaneous case was reported by a physician and describes the occurrence of MUSCULAR WEAKNESS (Deterioration to the point that he cannot hold a fork or tie his shoelaces) and HYPOKINESIA (he also cannot go to the bathroom on his own) in a 69-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 039K20A15) for COVID-19 vaccination. The patient's past medical history included Neuropathy (this decreased her mobility and weakened it (tenderness in the hands) but it had been improving well.) in November 2020. On 29-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 30-Jan-2021, the patient experienced MUSCULAR WEAKNESS (Deterioration to the point that he cannot hold a fork or tie his shoelaces) and HYPOKINESIA (he also cannot go to the bathroom on his own). At the time of the report, MUSCULAR WEAKNESS (Deterioration to the point that he cannot hold a fork or tie his shoelaces) and HYPOKINESIA (he also cannot go to the bathroom on his own) 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. concomitantly, in Nov-2020, Patient took only a pill at atb (Livoaquam). No treatment related information has been reported.

Other Meds:

Current Illness:

ID: 1552708
Sex: F
Age: 33
State: TX

Vax Date: 01/29/2021
Onset Date: 01/29/2021
Rec V Date: 08/13/2021
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Symptoms: Exposure during pregnancy; This spontaneous prospective pregnancy case was reported by a health care professional and describes the occurrence of EXPOSURE DURING PREGNANCY (Exposure during pregnancy) in a 34-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 043L20A) for COVID-19 vaccination. The patient's past medical history included Infertility, Spontaneous abortion on 21-Jul-2020 and Alcohol use (1 to 4 drinks a week). On 29-Jan-2021 at 1:00 PM, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. The patient's last menstrual period was on 27-Aug-2020 and the estimated date of delivery was 03-Jun-2021. On 29-Jan-2021, the patient experienced EXPOSURE DURING PREGNANCY (Exposure during pregnancy). The patient received mRNA-1273 (Moderna COVID-19 Vaccine) beginning around the twenty-second week of the pregnancy. On 29-Jan-2021, EXPOSURE DURING PREGNANCY (Exposure during pregnancy) had resolved. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 15-Nov-2020, Prenatal screening test: normal (normal) Normal. On 21-Dec-2020, Aspartate aminotransferase: normal (normal) Normal. On 14-Jan-2021, Ultrasound foetal: normal (normal) normal. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. Concomitantly, on 01-Jan-2020, patient started taking Nature Made Prenatal orally once a day as prenatal vitamin. No treatment related information has been reported. On 15-Nov-2020, genetic test came with normal results.

Other Meds:

Current Illness:

ID: 1552709
Sex: M
Age:
State: NY

Vax Date: 01/31/2021
Onset Date: 02/05/2021
Rec V Date: 08/13/2021
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Symptoms: dizziness and could not stand up; dizziness and could not stand up; Chills; Nausea; This spontaneous case was reported by a consumer and describes the occurrence of DIZZINESS (dizziness and could not stand up), DYSSTASIA (dizziness and could not stand up), CHILLS (Chills) and NAUSEA (Nausea) in a 64-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 31-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 05-Feb-2021 at 6:00 AM, the patient experienced DIZZINESS (dizziness and could not stand up), DYSSTASIA (dizziness and could not stand up), CHILLS (Chills) and NAUSEA (Nausea). At the time of the report, DIZZINESS (dizziness and could not stand up), DYSSTASIA (dizziness and could not stand up), CHILLS (Chills) and NAUSEA (Nausea) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medications were reported. No treatment was taken by the patient.

Other Meds:

Current Illness:

ID: 1552710
Sex: F
Age:
State: TX

Vax Date: 01/27/2021
Onset Date: 02/04/2021
Rec V Date: 08/13/2021
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Symptoms: on her right arm, it became red; on her right arm, it became hot; on her right arm, it became itchy; This spontaneous case was reported by a consumer and describes the occurrence of ERYTHEMA (on her right arm, it became red), FEELING HOT (on her right arm, it became hot) and PRURITUS (on her right arm, it became itchy) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. Concurrent medical conditions included Shellfish allergy. On 27-Jan-2021, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 04-Feb-2021, the patient experienced ERYTHEMA (on her right arm, it became red), FEELING HOT (on her right arm, it became hot) and PRURITUS (on her right arm, it became itchy). The patient was treated with DIPHENHYDRAMINE HYDROCHLORIDE (BENADRYL [DIPHENHYDRAMINE HYDROCHLORIDE]) at an unspecified dose and frequency; Physical therapy (Patient put some cool thing on her arm.) for Erythema; Physical therapy (Patient put some cool thing on her arm.) for Feeling hot and Physical therapy (Patient put some cool thing on her arm.) for Pruritus. At the time of the report, ERYTHEMA (on her right arm, it became red) had not resolved and FEELING HOT (on her right arm, it became hot) and PRURITUS (on her right arm, it became itchy) was resolving. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medications were reported. Reporter did not allow further contact

Other Meds:

Current Illness: Shellfish allergy

ID: 1552711
Sex: F
Age: 65
State: PA

Vax Date: 02/05/2021
Onset Date: 02/05/2021
Rec V Date: 08/13/2021
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Symptoms: hives on upper left arm , upper left thigh , upper right thigh, upper right arm; This spontaneous case was reported by a consumer and describes the occurrence of URTICARIA (hives on upper left arm , upper left thigh , upper right thigh, upper right arm) in a 65-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 010M20A) for COVID-19 vaccination. No medical history was provided by the reporter. Concomitant products included INSULIN for an unknown indication. On 05-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 05-Feb-2021, the patient experienced URTICARIA (hives on upper left arm , upper left thigh , upper right thigh, upper right arm). The patient was treated with DIPHENHYDRAMINE HYDROCHLORIDE (BENADRYL [DIPHENHYDRAMINE HYDROCHLORIDE]) ongoing since an unknown date for Hives, at an unspecified dose and frequency. At the time of the report, URTICARIA (hives on upper left arm , upper left thigh , upper right thigh, upper right arm) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Concomitantly, patient was taking cholesterol shot, heart medications, and blood thinners.

Other Meds: INSULIN

Current Illness:

ID: 1552712
Sex: M
Age: 41
State: IL

Vax Date: 01/22/2021
Onset Date: 01/24/2021
Rec V Date: 08/13/2021
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Symptoms: Chest pain constantly (due to high heat in room); Malaise; Weakness; Fatigue; This spontaneous case was reported by a consumer and describes the occurrence of CHEST PAIN (Chest pain constantly (due to high heat in room)), MALAISE (Malaise), ASTHENIA (Weakness) and FATIGUE (Fatigue) in a 41-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. UNK) for COVID-19 vaccination. No Medical History information was reported. On 22-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 24-Jan-2021, the patient experienced CHEST PAIN (Chest pain constantly (due to high heat in room)), MALAISE (Malaise), ASTHENIA (Weakness) and FATIGUE (Fatigue). On 03-Feb-2021, CHEST PAIN (Chest pain constantly (due to high heat in room)) had resolved. At the time of the report, MALAISE (Malaise), ASTHENIA (Weakness) and FATIGUE (Fatigue) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medications were reported. No treatment related information has been reported.

Other Meds:

Current Illness:

ID: 1552713
Sex: F
Age: 74
State:

Vax Date: 01/27/2021
Onset Date: 02/05/2021
Rec V Date: 08/13/2021
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Symptoms: A spontaneous report was received from a consumer concerning a 74-years-old female patient who received Moderna's COVID-19 vaccine (mRNA-1273) and experienced events arm a rash/ rash, warm/ feeling hot, swollen/ peripheral swelling. The patient's medical history was not provided. No relevant concomitant medications were reported. On 27 Jan 2021, prior to the onset of the events the patient received their first of two planned doses of mRNA-1273 (lot/batch: 012M20A) intramuscularly for prophylaxis of COVID-19 infection. On 5 Feb 2021, the patient experienced the events arm a rash, warm, swollen. No treatment information was provided. Action taken with mRNA-1273 in response to the events was not reported. The outcome of events arm a rash, worm, swollen was unknown. Based on comment, Peripheral swelling (code to LLT/PT vaccination site swelling which is listed across labels) and Feeling hot (code to LLT/PT vaccination site warmth which is listed across labels)

Other Meds:

Current Illness:

ID: 1552714
Sex: F
Age: 55
State: NV

Vax Date: 02/02/2021
Onset Date: 02/02/2021
Rec V Date: 08/13/2021
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Symptoms: nonstop fever at 100Degrees; This spontaneous case was reported by a patient and describes the occurrence of PYREXIA (nonstop fever at 100Degrees) in a 55-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 007L20A) for COVID-19 vaccination. No Medical History information was reported. On 02-Feb-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-Feb-2021, the patient experienced PYREXIA (nonstop fever at 100Degrees). At the time of the report, PYREXIA (nonstop fever at 100Degrees) outcome was unknown. Not Provided DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 02-Feb-2021, Body temperature: 100degree High. No concomitant and treatment medication reported.

Other Meds:

Current Illness:

ID: 1552715
Sex: F
Age:
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Symptoms: Delayed reaction; Somnolence; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION COMPLICATION (Delayed reaction) 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) (Intramuscular) 1 dosage form. On an unknown date, the patient experienced VACCINATION COMPLICATION (Delayed reaction). At the time of the report, VACCINATION COMPLICATION (Delayed reaction) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Concomitant product use was not provided by the reporter. Treatment information was not provided. Most recent FOLLOW-UP information incorporated above includes: On 01-Feb-2021: Follow up received on 22-Apr-2021 included no new information. On 22-Apr-2021: Followup was received on 22 April 2021. Reporter's last name from Patch to Hatch was added.Follow up received on 22-Apr-2021 included no new information.

Other Meds:

Current Illness:

ID: 1552716
Sex: F
Age:
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Vax Date:
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Rec V Date: 08/13/2021
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Symptoms: large red mark around vaccination area that lasted 9 days; A spontaneous report was received from a Consumer concerning a 2021--years-old female patient who received Moderna's COVID-19 vaccine (mRNA-1273) and experienced events large red mark around vaccination area that lasted 9 days. The patient's medical history was not provided. No relevant concomitant medications were reported. On 15 Jan 2021, prior to the onset of the events the patient received their first of two planned doses of mRNA-1273 (lot batch: Unknown) intramuscularly for prophylaxis of COVID-19 infection. On an unknown date, the patient experienced the events large red mark around vaccination area that lasted 9 days. No treatment information was provided. Action taken with mRNA-1273 in response to the events was not reported. On an unknown date the outcome of events include, large red mark around vaccination area that lasted 9 days was not reported. Based on comment Injection site erythema coded as Vaccination site erythema

Other Meds:

Current Illness:

ID: 1552717
Sex: F
Age:
State: MA

Vax Date: 02/10/2021
Onset Date:
Rec V Date: 08/13/2021
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Symptoms: feels like there is a rod in her arm; proceeded to dry-heave; feeling abnormal; Vaccination site reaction; felt really achy in her hips; have not regained her normal level of energy; pretty good headache; felt like she was doing shoulder press for a month nonstop; A spontaneous report was received from a consumer concerning a 53-years-old female patient who received Moderna's COVID-19 vaccine (mRNA-1273) and experienced events pretty bad reaction, pretty serious vomiting, immediate reaction, massive rush up her chest into her neck, like an adrenaline sensation, felt high and buzzed up, felt a little funny, felt creaky and foggy, felt really achy in her hips, lethargic, vomited all over, 3 rounds of vomiting, didn`t feel great, arm was really sore, felt like she was doing shoulder press for a month nonstop, felt a little foggy, proceeded to dry-heave, was in bed for 2 and half days, pretty good headache, appetite been off, sleep been off, feels like there is a rod in her arm, have not regained her normal level of energy. The patient's medical history was not provided. No relevant concomitant medications were reported. On 10 Feb 2021, prior to the onset of the events the patient received first of two planned doses of mRNA-1273 (lot/batch: 026120A) via unknown route in the left arm for prophylaxis of COVID-19 infection. On an unknown date, the patient experienced the event(s) pretty bad reaction, pretty serious vomiting, immediate reaction, massive rush up her chest into her neck, like an adrenaline sensation, felt high and buzzed up, felt a little funny, felt creaky and foggy, felt really achy in her hips, lethargic, vomited all over, 3 rounds of vomiting, didn`t feel great, arm was really sore, felt like she was doing shoulder press for a month nonstop, felt a little foggy, proceeded to dry-heave, Was in bed for 2 and half days, pretty good headache, appetite been off, sleep been off, feels like there is a rod in her arm, have not regained her normal level of energy.Consent for safety to follow-up was received. Treatment details included none Action taken with mRNA-1273 in response to the events was not reported. The outcome of event(s), pretty bad reaction, pretty serious vomiting, immediate reaction, massive rush up her chest into her neck, like an adrenaline sensation, felt high and buzzed up, felt a little funny, felt creaky and foggy, felt really achy in her hips, lethargic, vomited all over, 3 rounds of vomiting, didn`t feel great, arm was really sore, felt like she was doing shoulder press for a month nonstop, felt a little foggy, proceeded to dry-heave was in bed for 2 and half days, pretty good headache, appetite been off, sleep been off, feels like there is a rod in her arm, have not regained her normal level of energy was unknown. Based on MSA comment, Anxiety, Feeling abnormal, Euphoric, and Malaise is deleted.

Other Meds:

Current Illness:

ID: 1552718
Sex: F
Age: 60
State: CA

Vax Date: 02/02/2021
Onset Date: 02/03/2021
Rec V Date: 08/13/2021
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Symptoms: Still in bed; had strong reactions; Sore arm; Chills; Foggy brain; Diarrhea; Headache; No appetite; Felt clammy; Weakness; Raspy throat; A spontaneous report was received from a consumer concerning his wife, who is a 60-years-old female patient received Moderna's COVID-19 vaccine (mRNA-1273) and experienced events had strong reactions, sore arm, chills, foggy brain, diarrhea, headache, no appetite, felt clammy, weakness, raspy throat, still in bed. The patient's medical history was lupus, Sjogren's syndrome, allergic to sulfa drugs and passion fruit. Concomitant medications reported were prednisone, lubiprostone, aripiprazole, acetylsalicylic acid, carisoprodol, diltiazem hydrochloride, escitalopram oxalate, folic acid, hydroxychloroquine sulfate, lamotrigine, levothyroxine sodium, lorazepam, metoprolol succinate, sumatriptan succinate, tramadol hydrochloride, prazosin, gabapentin for drug use for unknown indication. On 2 Feb 2021, prior to the onset of the events the patient received first of two planned doses of mRNA-1273 (lot/batch: 027L20A) via unknown route in the left arm for prophylaxis of COVID-19 infection. On 3 Feb 2021, the patient experienced the events strong reactions. About 1 day later she had a sore arm, chills, a foggy brain, diarrhea, headache, no appetite, felt clammy, had weakness, had a raspy throat and is still in bed. No treatment information was provided. Action taken with mRNA-1273 in response to the events was not reported. Based on comment Pain in extremity coded as Vaccination site pain and Adverse reaction coded as Vaccination adverse reaction/PT Vaccination complication The outcome of events had strong reactions, sore arm, chills, foggy brain, diarrhea, headache, no appetite, felt clammy, weakness, raspy throat, still in bed was unknown.

Other Meds: PREDNISONE; AMITIZA; ARIPIPRAZOLE; BABY ASPIRIN; CARISOPRODOL; CARTIA XT; LEXAPRO; FOLIC ACID; PLAQUENIL S; LAMICTAL; SYNTHROID; LORAZEPAM; TOPROL XL; IMITREX DF; ULTRAM ER; PRAZOSIN; NEURONTIN

Current Illness: Drug allergy (Sulfa drugs); Fruit allergy

ID: 1552719
Sex: F
Age:
State: FL

Vax Date: 02/01/2021
Onset Date: 02/01/2021
Rec V Date: 08/13/2021
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Symptoms: Arm is hurting/Arm is really sore; Limb discount; A Spontaneous report was received from a consumer, concerning herself, a female patient of unknown age, who received Moderna's COVID-19 vaccine (m-RNA-1273) and experienced the events, arm is hurting, arm really sore, can't even lift it. The patient's medical history was not provided. No relevant concomitant medications were reported. On an unknown date, the patient received their first of two planned doses of mRNA-1273, intramuscularly in the left arm. On 01-FEB-2021, prior to the onset of the events, the patient received their second of two planned doses of mRNA-1273 (Lot number: unknown) intramuscularly, in the left arm, for the prophylaxis of COVID-19 infection. On 01-FEB-2021, the patient experienced the events, arm is hurting, arm really sore, can't even lift it. No treatment information was provided. Action taken with mRNA-1273 in response to the events was not applicable. The outcome of events, arm is hurting, arm really sore, can't even lift it, was unknown at the time of this report. Based on MSA comment Pain in extremity coded as Vaccination adverse reaction and Limb discomfort coded Vaccination site movement impairment

Other Meds:

Current Illness:

ID: 1552720
Sex: F
Age: 35
State: FL

Vax Date: 02/05/2021
Onset Date: 02/05/2021
Rec V Date: 08/13/2021
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Symptoms: pain; pain; bedridden; pain; body aches; Fatigue; fever; This spontaneous case was reported by a consumer and describes the occurrence of EYE PAIN (pain), EAR PAIN (pain), BEDRIDDEN (bedridden), MYALGIA (body aches) and FATIGUE (Fatigue) in a 35-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 05-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 05-Feb-2021, the patient experienced MYALGIA (body aches), FATIGUE (Fatigue) and PYREXIA (fever). On an unknown date, the patient experienced EYE PAIN (pain), EAR PAIN (pain), BEDRIDDEN (bedridden) and HEADACHE (pain). The patient was treated with NAPROXEN (MOTRIN [NAPROXEN]) at an unspecified dose and frequency. At the time of the report, EYE PAIN (pain), EAR PAIN (pain), BEDRIDDEN (bedridden), MYALGIA (body aches), FATIGUE (Fatigue), PYREXIA (fever) and HEADACHE (pain) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No relevant concomitant medications were reported. Reporter did not allow further contact

Other Meds:

Current Illness:

ID: 1552721
Sex: M
Age:
State: NV

Vax Date: 02/01/2021
Onset Date: 02/03/2021
Rec V Date: 08/13/2021
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Symptoms: rash on his neck and lower legs; This spontaneous case was reported by a consumer and describes the occurrence of RASH (rash on his neck and lower legs) in a male patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 007M20A) for COVID-19 vaccination. No Medical History information was reported. On 01-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 03-Feb-2021, the patient experienced RASH (rash on his neck and lower legs). At the time of the report, RASH (rash on his neck and lower legs) outcome was unknown. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medication was reported. No treatment was reported. Upon in internal review on 21 May 2021, the age was corrected to unknown age.

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ID: 1552722
Sex: M
Age:
State: TX

Vax Date: 01/21/2021
Onset Date: 01/27/2021
Rec V Date: 08/13/2021
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Symptoms: COVID-19; This spontaneous case was reported by a nurse and describes the occurrence of COVID-19 (COVID-19) in a 41-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. Concurrent medical conditions included Hypertension. On 21-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 27-Jan-2021, the patient experienced COVID-19 (COVID-19). At the time of the report, COVID-19 (COVID-19) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 27-Jan-2021, SARS-CoV-2 test: positive (Positive) SARS-CoV-2 test Positive. 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 relevant concomitant medications were reported. Treatment information was not provided. This case was linked to MOD-2021-025817 (Patient Link). Most recent FOLLOW-UP information incorporated above includes: On 24-Jun-2021: Follow-up information received on 24-JUN-2021 contains no new information. On 24-Jun-2021: Follow-up information received on 24-JUN-2021 contains no new information.

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Current Illness: Hypertension

Total 2021 VAERS Injuries: 599,999

Page last modified: 03 October 2021 5:28pm