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: 1562796
Sex: F
Age: 67
State: PA

Vax Date: 01/25/2021
Onset Date: 03/01/2021
Rec V Date: 08/15/2021
Hospital:

Vax Type:
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Symptom List:

Symptoms: Swollen lips; 6 inch whelps on her torso, hip and butt; This spontaneous case was reported by a consumer and describes the occurrence of URTICARIA (6 inch whelps on her torso, hip and butt) and LIP SWELLING (Swollen lips) in a 67-year-old female patient who received mRNA-1273 (COVID 19 Vaccine Moderna) for COVID-19 vaccination. The patient's past medical history included No adverse event (medical history not reported). On 25-Jan-2021, the patient received first dose of mRNA-1273 (COVID 19 Vaccine Moderna) (Intramuscular) 1 dosage form. On 25-Feb-2021, received second dose of mRNA-1273 (COVID 19 Vaccine Moderna) (unknown route) dosage was changed to 1 dosage form. On 01-Mar-2021, the patient experienced URTICARIA (6 inch whelps on her torso, hip and butt). On an unknown date, the patient experienced LIP SWELLING (Swollen lips). At the time of the report, URTICARIA (6 inch whelps on her torso, hip and butt) and LIP SWELLING (Swollen lips) outcome was unknown. The action taken with mRNA-1273 (COVID 19 Vaccine Moderna) (Unknown Route) and mRNA-1273 (COVID 19 Vaccine Moderna) (Intramuscular) was unknown.; Reporter's Comments: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.

Other Meds:

Current Illness:

ID: 1562797
Sex: F
Age:
State: OH

Vax Date:
Onset Date:
Rec V Date: 08/15/2021
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Symptom List:

Symptoms: Temperature; Sweats; A Spontaneous report was received from consumer concerning a unspecified age, female patient , Modern's COVID-19 vaccine(mRNA 1273) and experienced temperature and sweats. The patient medical history was not provided by the reporter. Concomitant medications were not provided by the reporter. On unspecified date, prior to the onset of the events, the patient received their first of two planned doses of mRNA-1273 , via unknown route and unknown anatomical location for prophylaxis of COVID-19 infection. After receiving the first dose the patient experienced Temperature and sweats. Treatment history was not provided by the reporter. Action taken with mRNA-1273 in response to the events was unknown. The outcome of the event temperature and sweats were unknown.

Other Meds:

Current Illness:

ID: 1562798
Sex: F
Age: 70
State: MI

Vax Date: 03/04/2021
Onset Date: 03/04/2021
Rec V Date: 08/15/2021
Hospital:

Vax Type:
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Symptoms: tinny taste in the back of my mouth; rash on my arm; face was pink; A spontaneous report was received from a consumer, concerning a 70 years adult female patient, who received Moderna COVID-19 Vaccine and experienced 1 dose. The patient's medical history was not provided. The concomitant products was not provided. On 04-Mar-2021,prior to the onset of events,the patient received the first dose of mRNA-1273(lot number: 029AD1A) and route of administration is unknown route for COVID-19 infection prophylaxis. The treatment includes that Patient reports putting Benadryl on her arm today 04Mar2021. Action taken with mRNA-1273 in response to the events were not reported. The Outcome of the event (Rash,Dysgeusia,Rosacea) was considered to be not resolved at the time of this report.

Other Meds:

Current Illness:

ID: 1562799
Sex: F
Age: 84
State: CA

Vax Date: 02/04/2021
Onset Date: 02/04/2021
Rec V Date: 08/15/2021
Hospital:

Vax Type:
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Symptom List:

Symptoms: swollen; red; itchy; COVID arm; A spontaneous report was received from a consumer concerning a 84-years-old female patient who received Moderna's COVID-19 vaccine (mRNA-1273) and experienced events swollen, red, itchy, covid arm. The patient's medical history was not provided. No relevant concomitant medications were reported. On 4 Feb 2021, prior to the onset of the events the patient received first of two planned doses of mRNA-1273 (lot/batch: Unknown) intramuscularly in the left deltoid for prophylaxis of COVID-19 infection. On 4 Feb 2021, the patient experienced the event(s) swollen, red, itchy, covid arm. Treatment details included None. Action taken with mRNA-1273 in response to the events was not reported. On 11 Feb 2021 the outcome of event(s), swollen, itchy, covid arm was resolved. The outcome of event(s), red was unknown.

Other Meds:

Current Illness:

ID: 1562800
Sex: F
Age: 56
State: AL

Vax Date: 01/16/2021
Onset Date: 01/17/2021
Rec V Date: 08/15/2021
Hospital:

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Symptom List:

Symptoms: Severe joint pain; Muscle pain in chest and arms; Really bad leg cramps; Legs feel like sciatic overload; Heart rate went up to between 92-98 beats per; This spontaneous case was reported by an other health care professional and describes the occurrence of MUSCLE SPASMS (Really bad leg cramps), SCIATICA (Legs feel like sciatic overload), HEART RATE INCREASED (Heart rate went up to between 92-98 beats per), ARTHRALGIA (Severe joint pain) and MYALGIA (Muscle pain in chest and arms) in a 56-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 037K20A) for COVID-19 vaccination. The patient's past medical history included Ear infection (Reported data: In the past month I had two Rocephin shots for ear infections. Treatment: Rocephin shots) in January 2021. Previously administered products included for Product used for unknown indication: Flu shot on 16-Dec-2020 and Pneumovax shot on 28-Dec-2020. Concurrent medical conditions included Type II diabetes mellitus. On 16-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 17-Jan-2021, the patient experienced MUSCLE SPASMS (Really bad leg cramps), SCIATICA (Legs feel like sciatic overload), HEART RATE INCREASED (Heart rate went up to between 92-98 beats per) and MYALGIA (Muscle pain in chest and arms). On an unknown date, the patient experienced ARTHRALGIA (Severe joint pain). In February 2021, MUSCLE SPASMS (Really bad leg cramps) had resolved. At the time of the report, SCIATICA (Legs feel like sciatic overload), HEART RATE INCREASED (Heart rate went up to between 92-98 beats per), ARTHRALGIA (Severe joint pain) and MYALGIA (Muscle pain in chest and arms) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 17-Jan-2021, Heart rate: 92-98 Inconclusive. 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. Concomitant product use was not provided by the reporter. Treatment for the events included steroids.

Other Meds:

Current Illness: Type II diabetes mellitus

ID: 1562801
Sex: F
Age: 37
State: NY

Vax Date: 02/26/2021
Onset Date: 02/26/2021
Rec V Date: 08/15/2021
Hospital:

Vax Type:
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Symptom List:

Symptoms: Hives; Sore Arm; Sore wrist; red rash on chest; nerve pain - right arm; tremors - right arm; weakness - right arm; burning sensation -right arm; itchiness; Rash near her ncek/rash on left side neck/collar bone; This spontaneous case was reported by a consumer and describes the occurrence of URTICARIA (Hives), PAIN IN EXTREMITY (Sore Arm), NEURALGIA (nerve pain - right arm), TREMOR (tremors - right arm) and MUSCULAR WEAKNESS (weakness - right arm) in a 37-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 014M20A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. The patient's past medical history included Nerve damage. Concurrent medical conditions included Allergy to chemicals (Contrast dye) and Allergy to vaccine (Allergy to Gardasil vaccine). On 26-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 26-Feb-2021, the patient experienced RASH (Rash near her ncek/rash on left side neck/collar bone). On 27-Feb-2021, the patient experienced NEURALGIA (nerve pain - right arm), TREMOR (tremors - right arm), MUSCULAR WEAKNESS (weakness - right arm), BURNING SENSATION (burning sensation -right arm) and PRURITUS (itchiness). On 02-Mar-2021, the patient experienced RASH ERYTHEMATOUS (red rash on chest). On an unknown date, the patient experienced URTICARIA (Hives), PAIN IN EXTREMITY (Sore Arm) and ARTHRALGIA (Sore wrist). The patient was treated with DIPHENHYDRAMINE HYDROCHLORIDE (BENADRYL [DIPHENHYDRAMINE HYDROCHLORIDE]) ongoing since an unknown date for Burning sensation, Rash, Hives and Pruritus, at a dose of 2 x 25 mg tablets; FEXOFENADINE HYDROCHLORIDE (ALLEGRA) ongoing since an unknown date for Rash, at an unspecified dose and frequency; ALPRAZOLAM (ATARAX [ALPRAZOLAM]) ongoing since an unknown date for Rash erythematous, at a dose of 25 mg; EPINEPHRINE (EPIPEN) ongoing since an unknown date for Hives, at an unspecified dose and frequency and LORAZEPAM (ATIVAN) ongoing since an unknown date at an unspecified dose and frequency. On 27-Feb-2021, RASH (Rash near her ncek/rash on left side neck/collar bone) had resolved. On 08-Mar-2021, NEURALGIA (nerve pain - right arm), TREMOR (tremors - right arm), MUSCULAR WEAKNESS (weakness - right arm), BURNING SENSATION (burning sensation -right arm) and PRURITUS (itchiness) had resolved. On 23-Mar-2021, RASH ERYTHEMATOUS (red rash on chest) had resolved. At the time of the report, URTICARIA (Hives), PAIN IN EXTREMITY (Sore Arm) and ARTHRALGIA (Sore wrist) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. The patient reported that following her visit to the neurologist on 12-Mar-2021, she completed antibody testing as ordered by her allergist and was found to have antibodies present. She reported that most of her symptoms had improved by the time she was ready for Dose 2 on 26March2021. However, MD at vaccination site told her she was not able to get the Dose 2 of Moderna vaccine or any mRNA vaccine due to the mild hives that she experienced at Dose 1 as per CDC guidelines. Moreover, patient also contacted CDC to ask f she can get Dose 2 of Moderna and Johnson & Johnson COVID-19 vaccine was recommended but that there was no data on the mixing of vaccinations and it would be at the discretion of the caller and primary care physician. Concomitant medications were not reported Most recent FOLLOW-UP information incorporated above includes: On 30-Apr-2021: Significant follow-up appended

Other Meds:

Current Illness: Allergy to chemicals (Contrast dye); Allergy to vaccine (Allergy to Gardasil vaccine.)

ID: 1562802
Sex: F
Age: 87
State: AZ

Vax Date: 02/24/2021
Onset Date: 02/24/2021
Rec V Date: 08/15/2021
Hospital:

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Symptoms: Dizzy; This case was received via an unknown source (no reference has been entered for a health authority or license partner) on 04-Mar-2021 and was forwarded to the company on 05-Mar-2021. This spontaneous case was reported by a consumer and describes the occurrence of DIZZINESS (Dizzy) in an 87-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 010A21A) for COVID-19 vaccination. No medical history was reported. Concomitant products included ALPRAZOLAM (XANAX) for an unknown indication. On 24-Feb-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 24-Feb-2021, the patient experienced DIZZINESS (Dizzy). At the time of the report, DIZZINESS (Dizzy) outcome was unknown. Treatment details were not provided. Most recent FOLLOW-UP information incorporated above includes: On 30-Apr-2021: No specific follow-up information recorded.

Other Meds: XANAX

Current Illness:

ID: 1562803
Sex: F
Age: 65
State: OH

Vax Date: 02/17/2021
Onset Date:
Rec V Date: 08/15/2021
Hospital:

Vax Type:
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Symptoms: sweats; This case was received via an unknown source (no reference has been entered for a health authority or license partner) on 04-Mar-2021 and was forwarded to Moderna on 04-Mar-2021. This spontaneous case was reported by a consumer and describes the occurrence of HYPERHIDROSIS (sweats) 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 17-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 an unknown date, the patient experienced HYPERHIDROSIS (sweats). At the time of the report, HYPERHIDROSIS (sweats) outcome was unknown. The patient reported that she had temperature and sweats following her first dose of vaccine. Concomitant and treatment details were not reported. This case was linked to MOD-2021-034865, MOD-2021-034850 (Patient Link).

Other Meds:

Current Illness:

ID: 1562804
Sex: F
Age: 77
State: SD

Vax Date: 02/08/2021
Onset Date: 02/09/2021
Rec V Date: 08/15/2021
Hospital:

Vax Type:
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Symptom List:

Symptoms: Pain in the left shoulder going to elbow; Fatigue; Nausea; Headache; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (Pain in the left shoulder going to elbow), FATIGUE (Fatigue), NAUSEA (Nausea) and HEADACHE (Headache) in a 78-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 007M20A) for COVID-19 vaccination. The patient's past medical history included COVID-19 in November 2020. On 08-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 09-Feb-2021, the patient experienced PAIN IN EXTREMITY (Pain in the left shoulder going to elbow), FATIGUE (Fatigue), NAUSEA (Nausea) and HEADACHE (Headache). At the time of the report, PAIN IN EXTREMITY (Pain in the left shoulder going to elbow), FATIGUE (Fatigue), NAUSEA (Nausea) and HEADACHE (Headache) had not resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medications reported by investigator o No treatment medications provided by the reporter.

Other Meds:

Current Illness:

ID: 1562805
Sex: F
Age: 64
State: MI

Vax Date: 08/11/2021
Onset Date: 08/11/2021
Rec V Date: 08/15/2021
Hospital:

Vax Type:
Manufacturer:
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Lab Data:

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Symptom List:

Symptoms: Error: Booster Given Too Early-

Other Meds:

Current Illness:

ID: 1562806
Sex: M
Age: 17
State: TX

Vax Date: 04/29/2021
Onset Date: 04/29/2021
Rec V Date: 08/15/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
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Lab Data:

Allergies:

Symptom List:

Symptoms: Error: Patient Too Young for Vaccine Administered-

Other Meds:

Current Illness:

ID: 1562807
Sex: M
Age: 51
State: CT

Vax Date: 08/14/2021
Onset Date: 08/14/2021
Rec V Date: 08/15/2021
Hospital:

Vax Type:
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Lab Data:

Allergies:

Symptom List:

Symptoms: Error: Wrong Vaccine Formulation (ex. different manufact. initial and booster)-

Other Meds:

Current Illness:

ID: 1562808
Sex: M
Age:
State: TX

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

Vax Type:
Manufacturer:
Vax Name:
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Lab Data:

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Symptom List:

Symptoms: Feel like shut. High fever. Body aches.

Other Meds:

Current Illness:

ID: 1562809
Sex: F
Age: 62
State: PA

Vax Date: 07/21/2021
Onset Date: 07/28/2021
Rec V Date: 08/15/2021
Hospital:

Vax Type:
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Lab Data:

Allergies:

Symptom List:

Symptoms: Site: Swelling at Injection Site-Mild, Systemic: Allergic: Difficulty Breathing-Mild, Systemic: Allergic: Itch Generalized-Severe, Systemic: Allergic: Rash Generalized-Severe, Systemic: Abdominal Pain-Mild, Systemic: Body Aches Generalized-Medium, Systemic: Chills-Mild, Systemic: Confusion-Mild, Systemic: Diarrhea-Medium, Systemic: Dizziness / Lightheadness-Medium, Systemic: Exhaustion / Lethargy-Medium, Systemic: Fever-Mild, Systemic: Flushed / Sweating-Severe, Systemic: Headache-Mild, Systemic: Nausea-Severe, Systemic: Tingling (specify: facial area, extemities)-Medium, Systemic: Tinnitus-Severe, Systemic: Visual Changes/Disturbances-Medium, Systemic: Vomiting-Severe, Systemic: Weakness-Medium

Other Meds:

Current Illness:

ID: 1562810
Sex: M
Age: 60
State: FL

Vax Date: 07/24/2021
Onset Date: 07/30/2021
Rec V Date: 08/15/2021
Hospital:

Vax Type:
Manufacturer:
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Vax Site:

Lab Data:

Allergies:

Symptom List:

Symptoms: Site: Redness at Injection Site-Severe, Site: Swelling at Injection Site-Severe, Systemic: Allergic: Rash Generalized-Severe, Systemic: Fever-Medium, Systemic: Numbness (specify: facial area, extremities)-Medium

Other Meds:

Current Illness:

ID: 1562811
Sex: M
Age: 78
State: LA

Vax Date: 07/26/2021
Onset Date: 08/01/2021
Rec V Date: 08/15/2021
Hospital:

Vax Type:
Manufacturer:
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Lab Data:

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Symptom List:

Symptoms: Systemic: pneumonia-Mild, Additional Details: Per pt's wife, pt started feeling bad on 8/1/21 and ran a fever of 102. Pt went to doctor on 8/3/21 and was diagnosised with pneumonia. Pt is asymptomatic per wife and received antibiotics.

Other Meds:

Current Illness:

ID: 1562812
Sex: F
Age: 57
State: OH

Vax Date: 08/02/2021
Onset Date: 08/03/2021
Rec V Date: 08/15/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Site: Bruising at Injection Site-Medium, Site: Swelling at Injection Site-Mild

Other Meds:

Current Illness:

ID: 1562813
Sex: F
Age: 15
State: TX

Vax Date: 08/14/2021
Onset Date: 08/14/2021
Rec V Date: 08/15/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Systemic: Exhaustion / Lethargy-Mild, Systemic: Fainting / Unresponsive-Medium, Additional Details: Pt fainted upon minutes after patient given vaccine. Pt was going by seat to sit down after getting vaccinated and brother was on deck for the vaccine. Before sitting down pt fainted and hit the floor. Patient was unresponsive for a few seconds and then recovered. Pt was complaining about headaches but reported to be okay. Asked pt and father multiple times if they were okay, they said they were fine. Pt sat for observation for 15 minutes and then left the pharmacy, fine.

Other Meds:

Current Illness:

ID: 1562814
Sex: F
Age: 56
State: IL

Vax Date: 06/03/2021
Onset Date: 06/03/2021
Rec V Date: 08/15/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
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Vax Site:

Lab Data:

Allergies:

Symptom List:

Symptoms: Error: Shoulder Joint Injury (prolonged pain, tingling, etc.)-

Other Meds:

Current Illness:

ID: 1562815
Sex: U
Age:
State: IL

Vax Date: 02/10/2021
Onset Date: 02/18/2021
Rec V Date: 08/15/2021
Hospital:

Vax Type:
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Lab Data:

Allergies:

Symptom List:

Symptoms: her lips were swollen; chills; headache; fatigue; blotching redness on her arm; little bit of itching; This case was received via an unknown source (no reference has been entered for a health authority or license partner) on 04-Mar-2021 and was forwarded to Moderna on 04-Mar-2021. Based on the current case data, this case has been classified as invalid. This spontaneous case was reported by a consumer and describes the occurrence of LIP SWELLING (her lips were swollen), ERYTHEMA (blotching redness on her arm), PRURITUS (little bit of itching), CHILLS (chills) and HEADACHE (headache) in a patient of an unknown age and gender 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 10-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 18-Feb-2021, the patient experienced ERYTHEMA (blotching redness on her arm) and PRURITUS (little bit of itching). On an unknown date, the patient experienced LIP SWELLING (her lips were swollen), CHILLS (chills), HEADACHE (headache) and FATIGUE (fatigue). The patient was treated with IBUPROFEN for Chills, Headache, Fatigue and Temperature elevation, at a dose of 200 mg once. On 21-Feb-2021, ERYTHEMA (blotching redness on her arm) and PRURITUS (little bit of itching) had resolved. At the time of the report, LIP SWELLING (her lips were swollen) outcome was unknown and CHILLS (chills), HEADACHE (headache) and FATIGUE (fatigue) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Reportedly, 3 weeks after being vaccinated, the patient stated started experiencing chills, headache, fatigue, and little bit of temperature, which resolved following treatment with ibuprofen. The patient questioned herself if this could be a delayed reaction from the vaccine or is this common and wanted to due diligence by reporting this to Moderna. Concomitant medications were not reported. Reporter did not allow further contact

Other Meds:

Current Illness:

ID: 1562816
Sex: F
Age: 35
State: OH

Vax Date: 08/14/2021
Onset Date: 08/15/2021
Rec V Date: 08/15/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: Body aches, my right arm where I got the injection is feels heavy, swollen feet, sore throat and tiredness.

Other Meds: Dulera

Current Illness: None

ID: 1562817
Sex: M
Age: 42
State: TX

Vax Date: 08/14/2021
Onset Date: 08/14/2021
Rec V Date: 08/15/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Systemic: Dizziness / Lightheadness-Medium, Systemic: Fainting / Unresponsive-Medium, Systemic: Flushed / Sweating-Medium

Other Meds:

Current Illness:

ID: 1562818
Sex: F
Age: 15
State: FL

Vax Date: 08/14/2021
Onset Date: 08/14/2021
Rec V Date: 08/15/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Error: Wrong Patient (documentation in system)-

Other Meds:

Current Illness:

ID: 1562819
Sex: F
Age: 60
State: FL

Vax Date: 08/14/2021
Onset Date: 08/14/2021
Rec V Date: 08/15/2021
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Symptom List:

Symptoms: Site: Pain at Injection Site-Mild, Site: Swelling at Injection Site-Mild, Additional Details: Patient reported pain and swelling at injection site. Swelling decreased within the hour but she was concerned because it hurt more than first dose. She declined follow up with MD, although RPh recommended follow up since patient was concerned.

Other Meds:

Current Illness:

ID: 1562820
Sex: M
Age: 24
State: IL

Vax Date: 08/14/2021
Onset Date: 08/14/2021
Rec V Date: 08/15/2021
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Symptom List:

Symptoms: Systemic: Dizziness / Lightheadness-Mild, Systemic: Flushed / Sweating-Mild, Systemic: Nausea-Mild

Other Meds:

Current Illness:

ID: 1562821
Sex: M
Age: 61
State:

Vax Date: 08/12/2021
Onset Date: 08/12/2021
Rec V Date: 08/15/2021
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Allergies: Ampicillin

Symptom List:

Symptoms: Had several hours of chills/shivering, followed by several hours of being extremely hot with some hallucinations. Fever with body aches from head to toe. Extremely lethargic for 24 hours or so. Still not back to 100% energy level, but getting close.

Other Meds: Atorvastatin

Current Illness: None

ID: 1562822
Sex: F
Age: 46
State: FL

Vax Date: 08/13/2021
Onset Date: 08/13/2021
Rec V Date: 08/15/2021
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Allergies: no

Symptom List:

Symptoms: Onset of numbness/tingling in lips was around 4 hours later after receiving shot. Numbness area expanded around 35 hours later to throat mouth area. Numbness/swelling continues to irritate throat/lips area persists with feeling of little swelling, but not impacting any breathing. I continue to monitor and plan on going to a dr if breathing becomes compromised, if symptoms remain the same - I will notify my doctor Monday morning for documentation purposes and advice on if I should receive 2nd shot?

Other Meds: Multivitamin, turmeric

Current Illness: no

ID: 1562823
Sex: M
Age: 29
State: VA

Vax Date: 08/14/2021
Onset Date: 08/14/2021
Rec V Date: 08/15/2021
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Symptom List:

Symptoms: Systemic: Fainting / Unresponsive-Severe

Other Meds:

Current Illness:

ID: 1562824
Sex: M
Age: 78
State: AZ

Vax Date: 02/09/2021
Onset Date: 02/22/2021
Rec V Date: 08/15/2021
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Symptom List:

Symptoms: mild, consistent and persistent itching all over his body; This case was received via an unknown source (no reference has been entered for a health authority or license partner) on 04-Mar-2021 and was forwarded to Moderna on 04-Mar-2021. This spontaneous case was reported by a consumer and describes the occurrence of PRURITUS (mild, consistent and persistent itching all over his body) in a 78-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 031M20A) for COVID-19 vaccination. No Medical History information was reported. On 09-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 22-Feb-2021, the patient experienced PRURITUS (mild, consistent and persistent itching all over his body). At the time of the report, PRURITUS (mild, consistent and persistent itching all over his body) outcome was unknown. 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. Reportedly, the patient already reached out to Centers for Disease Control and Prevention (CDC) to ask if he can proceed with the 2nd dose after experiencing these symptoms and CDC advised him not to proceed with it. He called to get Moderna's recommendation on his situation before going to his healthcare provider for advise. Concomitant medications and treatment details were not reported.

Other Meds:

Current Illness:

ID: 1562825
Sex: M
Age: 32
State: NC

Vax Date: 07/24/2021
Onset Date: 07/25/2021
Rec V Date: 08/15/2021
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Symptom List:

Symptoms: Systemic: Numbness (specify: facial area, extremities)-Medium, Additional Details: Patient complained of numbness in lower extremeties on the inside of both legs from knee down. Denies any previous injury or surgery or inflammation in that area. I did not want to give dosage 2 until we have knowledge of what may have occured and someone confirms that he is well enough to receive.

Other Meds:

Current Illness:

ID: 1562826
Sex: F
Age: 45
State: FL

Vax Date: 08/02/2021
Onset Date: 08/09/2021
Rec V Date: 08/15/2021
Hospital:

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Lab Data:

Allergies: None

Symptom List:

Symptoms: 7 days after injection, injection site developed a welt. The welt was tender, hot to the touch, swollen and itchy. 14 days after the injection, a red circle has developed. The circle is hot to the touch and tender.

Other Meds: Multi-vitamin, B12, Magnesium

Current Illness: None

ID: 1562827
Sex: F
Age: 66
State: NY

Vax Date: 08/14/2021
Onset Date: 08/14/2021
Rec V Date: 08/15/2021
Hospital:

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Symptom List:

Symptoms: Systemic: Chills-Severe, Systemic: Headache-Severe, Systemic: Hypertension-Severe, Additional Details: AFTER 15 MINUTES PT GOT UP AND STARTED NOT FELLING GOOD. BLOOD PRESSURE 215/182.. TAKEN AGAIN 205/180.. DAUGHTER CALLED AMBULANCE. SHE DECIDED NOT TO GO AFTER HER DAUGHTER BROUGHT HER HCTZ. WILL CALL MONDAY TO FOLLOW UP.

Other Meds:

Current Illness:

ID: 1562828
Sex: F
Age: 39
State: TN

Vax Date: 08/07/2021
Onset Date: 08/07/2021
Rec V Date: 08/15/2021
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Symptom List:

Symptoms: Systemic: Knot developed on right wrist approximately 2-3 hours after administration.-Mild

Other Meds:

Current Illness:

ID: 1562829
Sex: F
Age: 45
State: LA

Vax Date: 08/12/2021
Onset Date: 08/12/2021
Rec V Date: 08/15/2021
Hospital:

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Lab Data:

Allergies:

Symptom List:

Symptoms: Site: Redness at Injection Site-Medium, Systemic: Allergic: Rash (specify: facial area, extremeties)-Medium, Additional Details: Rash at injection site

Other Meds:

Current Illness:

ID: 1562830
Sex: F
Age: 44
State: TX

Vax Date: 08/10/2021
Onset Date: 08/10/2021
Rec V Date: 08/15/2021
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Symptom List:

Symptoms: Systemic: face numbness-Mild

Other Meds:

Current Illness:

ID: 1562831
Sex: F
Age: 31
State: AL

Vax Date: 08/14/2021
Onset Date: 08/14/2021
Rec V Date: 08/15/2021
Hospital:

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Symptom List:

Symptoms: Systemic: jaw tightness-Mild, Systemic: Numbness (specify: facial area, extremities)-Medium, Systemic: Tingling (specify: facial area, extemities)-Medium, Additional Details: experienced numbness and tingling from left shoulder down to left hand

Other Meds:

Current Illness:

ID: 1562832
Sex: F
Age: 22
State: TX

Vax Date: 04/24/2021
Onset Date: 04/25/2021
Rec V Date: 08/15/2021
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Lab Data:

Allergies: Eggs, wheat, dairy, grass

Symptom List:

Symptoms: The day after I got my 2nd shot, I felt really sick. I was dizzy, nauseous, extremely fatigued to where I almost passed out a couple times. My biggest concern was the fatigue and my blood pressure tanking. It got down to 90/60. The issue is that for the months following I had really bad gastrointestinal issues. I was constipated at times, and had diarrhea at other times, going about 8-10 times before it even hit noon (my average before this was once a day or not at all). I was dehydrated from using the bathroom so much so I was dizzy nauseous, light-headed, and fatigued constantly. I had a lot of abdomen pain and soreness. All of these symptoms occured after I got my 2nd dose and have continued until this very day. I went to my primary doctor in May/June, but she believed that I was having too many unrelated symptoms and that it was probably something I was eating (since I do have a few food allergies). I basically wasn?t having it and I went to get a second opinion at a diagnostic gastrointestinal doctor. I got a colonoscopy and endoscopy from him back in July and it was concluded that I had an ulcer in my colon, among other things like a polyp (also in my colon), gastritis, esophagitis, and internal hemorrhoids. Now the only one that is really important to this story, however, is the ulcer. I was told by the doctor?s assistant in my follow up appointment that I also have ischemic colitis and that that was how my ulcer was most likely formed- just having a drop in blood pressure for an extended period of time, not getting enough blood flow to my colon, causing an ulcer. She told me the ulcer will heal as my blood pressure rises, but I?m my whole life I?ve always had lower than average blood pressure so it can?t get high enough and I?m in a bit of a pickle.

Other Meds: Trazodone, abilify, lexapro, birth control

Current Illness: None

ID: 1562833
Sex: F
Age: 67
State: PA

Vax Date: 01/25/2021
Onset Date:
Rec V Date: 08/15/2021
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Symptom List:

Symptoms: broke out in whelps all over her body; swollen lips; A spontaneous report was received from a consumer concerning a 67-year old, female patient who received Moderna's COVID-19 vaccine (mRNA-1273) and broke out in welts all over her body. The patient's medical history was not provided. No relevant concomitant medications were reported. On 25 Jan 2021, patient received their first of two planned doses of mRNA-1273 (lot/batch: unknown) intramuscularly in the left arm for prophylaxis of COVID-19 infection. On an unknown date, the patient broke out in welts (reported as whelps) all over her body.Treatment details included diphenhydramine hydrochloride, and famotidine. Action taken with mRNA-1273 in response to the events was not reported. The outcome of event, broke out in whelps all over her body,was unknown.; Reporter's Comments: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.

Other Meds:

Current Illness:

ID: 1562834
Sex: F
Age: 50
State: MA

Vax Date: 07/31/2021
Onset Date: 07/31/2021
Rec V Date: 08/15/2021
Hospital:

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Allergies:

Symptom List:

Symptoms: Error: Wrong Vaccine Formulation (ex. different manufact. initial and booster)-

Other Meds:

Current Illness:

ID: 1562835
Sex: F
Age: 14
State: NY

Vax Date: 08/14/2021
Onset Date: 08/14/2021
Rec V Date: 08/15/2021
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Allergies: None

Symptom List:

Symptoms: 11 hours after vaccine developed very high fever 39.3 C, chills, feeling nauseous

Other Meds: None

Current Illness: None

ID: 1562836
Sex: F
Age: 17
State: CA

Vax Date: 08/13/2021
Onset Date: 08/13/2021
Rec V Date: 08/15/2021
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Symptom List:

Symptoms: Systemic: Flushed / Sweating-Mild, Systemic: Nausea-Mild, Systemic: Vomiting-Mild, Additional Details: Patient has a fear of needles. Reported always having trouble in past when giving blood. Patient felt flushed within a minute afterward. She also began to feel nauseaous and vomited some. She felt some stomach pain as well. She sat for nearly 30 minutes and felt better over time.

Other Meds:

Current Illness:

ID: 1562837
Sex: F
Age: 26
State: CT

Vax Date: 08/14/2021
Onset Date: 08/14/2021
Rec V Date: 08/15/2021
Hospital:

Vax Type:
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Lab Data:

Allergies:

Symptom List:

Symptoms: Systemic: Dizziness / Lightheadness-Medium, Systemic: Flushed / Sweating-Medium, Systemic: Hypotension-Mild, Systemic: Tingling (specify: facial area, extemities)-Mild, Additional Details: Tingling extremeties

Other Meds:

Current Illness:

ID: 1562838
Sex: F
Age: 70
State: FL

Vax Date: 08/14/2021
Onset Date: 08/14/2021
Rec V Date: 08/15/2021
Hospital:

Vax Type:
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Lab Data:

Allergies:

Symptom List:

Symptoms: Extreme soreness at site of injection. Significant weakness in both legs. Achiness in both legs, particularly from knees down.

Other Meds:

Current Illness:

ID: 1562839
Sex: F
Age: 47
State: CO

Vax Date: 07/28/2021
Onset Date: 07/28/2021
Rec V Date: 08/15/2021
Hospital:

Vax Type:
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Lab Data:

Allergies:

Symptom List:

Symptoms: Site: Bruising at Injection Site-Severe, Site: Itching at Injection Site-Severe, Site: Pain at Injection Site-Severe, Site: Redness at Injection Site-Severe, Site: Swelling at Injection Site-Severe, Systemic: Allergic: Rash (specify: facial area, extremeties)-Severe, Systemic: Chest Tightness / Heaviness / Pain-Severe, Systemic: Joint Pain-Severe, Systemic: Tingling (specify: facial area, extemities)-Severe, Additional Details: water like feeling in skin

Other Meds:

Current Illness:

ID: 1562840
Sex: F
Age: 54
State: VA

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

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Lab Data:

Allergies: None

Symptom List:

Symptoms: Bad body aches, freezing cold, mild headache , tiredness

Other Meds: Vit D, multivitamin, Singulair

Current Illness: Bronchitis pne month prior

ID: 1562841
Sex: F
Age: 50
State: MA

Vax Date: 06/26/2021
Onset Date: 06/26/2021
Rec V Date: 08/15/2021
Hospital:

Vax Type:
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Lab Data:

Allergies:

Symptom List:

Symptoms: Error: Wrong Vaccine Formulation (ex. different manufact. initial and booster)-

Other Meds:

Current Illness:

ID: 1562842
Sex: F
Age: 55
State: MI

Vax Date: 04/23/2021
Onset Date: 04/26/2021
Rec V Date: 08/15/2021
Hospital: Y

Vax Type:
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Lab Data:

Allergies: Ampicillin

Symptom List:

Symptoms: Extreme chills the first evening and progressed to extreme difficulty breathing and chest pains. I assumed it was the vaccine doing its job to build up my immunity. So I didn't head to the hospital until my breathing was extremely labored. At the hospital I was diagnosed with DVT in left leg and multiple pulmonary embolisms in both lungs. I had a very large blood clot in my left lung.

Other Meds: None

Current Illness: None

ID: 1562843
Sex: F
Age:
State:

Vax Date: 02/12/2021
Onset Date: 02/12/2021
Rec V Date: 08/15/2021
Hospital:

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Lab Data:

Allergies:

Symptom List:

Symptoms: Rash at the injection site; Redness at the injection site; Raised at the injection site; Broke out at the injection site; Itchiness at the injection site; This case was received via an unknown source (no reference has been entered for a health authority or license partner) on 04-Mar-2021 and was forwarded to Moderna on 05-Mar-2021. This spontaneous case was reported by a consumer (subsequently medically confirmed) and describes the occurrence of VACCINATION SITE LACERATION (Broke out at the injection site), VACCINATION SITE PRURITUS (Itchiness at the injection site), VACCINATION SITE RASH (Rash at the injection site), VACCINATION SITE ERYTHEMA (Redness at the injection site) and VACCINATION SITE SWELLING (Raised at the injection site) in a 66-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 024M20A) for COVID-19 vaccination. The patient's past medical history included Anaphylactic reaction (History of anaphylactic reaction to bug bite and medication). Concurrent medical conditions included Acid reflux (oesophageal). Concomitant products included PANTOPRAZOLE SODIUM SESQUIHYDRATE (PROTONIX [PANTOPRAZOLE SODIUM SESQUIHYDRATE]) for Acid reflux (oesophageal). On 12-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 12-Feb-2021, the patient experienced VACCINATION SITE LACERATION (Broke out at the injection site), VACCINATION SITE PRURITUS (Itchiness at the injection site), VACCINATION SITE ERYTHEMA (Redness at the injection site) and VACCINATION SITE SWELLING (Raised at the injection site). On 19-Feb-2021, the patient experienced VACCINATION SITE RASH (Rash at the injection site). The patient was treated with DIPHENHYDRAMINE HYDROCHLORIDE (BENADRYL [DIPHENHYDRAMINE HYDROCHLORIDE]) ongoing since an unknown date for Vaccination site rash, Vaccination site erythema, Vaccination site laceration, Vaccination site swelling and Vaccination site pruritus, at an unspecified dose and frequency. At the time of the report, VACCINATION SITE LACERATION (Broke out at the injection site), VACCINATION SITE PRURITUS (Itchiness at the injection site), VACCINATION SITE RASH (Rash at the injection site), VACCINATION SITE ERYTHEMA (Redness at the injection site) and VACCINATION SITE SWELLING (Raised at the injection site) 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. Reporter did not allow further contact

Other Meds: PROTONIX [PANTOPRAZOLE SODIUM SESQUIHYDRATE]

Current Illness: Acid reflux (oesophageal)

ID: 1562844
Sex: F
Age: 48
State: CA

Vax Date: 02/19/2021
Onset Date:
Rec V Date: 08/15/2021
Hospital:

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Lab Data:

Allergies:

Symptom List:

Symptoms: Severe Migraine; Swollen Lymph node; foggy brain; ear pain; fatigue; This case was received via an unknown source (no reference has been entered for a health authority or license partner) on 04-Mar-2021 and was forwarded to Moderna on 05-Mar-2021. This spontaneous case was reported by a nurse (subsequently medically confirmed) and describes the occurrence of MIGRAINE (Severe Migraine), LYMPHADENOPATHY (Swollen Lymph node), FEELING ABNORMAL (foggy brain), EAR PAIN (ear pain) and FATIGUE (fatigue) in a 48-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 029L20A) for COVID-19 vaccination. No medical history was reported. Concomitant products included IBUPROFEN for an unknown indication. On 19-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On an unknown date, the patient experienced MIGRAINE (Severe Migraine), LYMPHADENOPATHY (Swollen Lymph node), FEELING ABNORMAL (foggy brain), EAR PAIN (ear pain) and FATIGUE (fatigue). At the time of the report, MIGRAINE (Severe Migraine), LYMPHADENOPATHY (Swollen Lymph node), FEELING ABNORMAL (foggy brain), EAR PAIN (ear pain) and FATIGUE (fatigue) 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. Treatment details were not provided

Other Meds: IBUPROFEN

Current Illness:

ID: 1562845
Sex: M
Age: 57
State: CT

Vax Date: 03/03/2021
Onset Date: 03/03/2021
Rec V Date: 08/15/2021
Hospital:

Vax Type:
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Lab Data:

Allergies:

Symptom List:

Symptoms: Swollen arm; felt hyper; could not sleep; Hand little shaky; This case was received via an unknown source (no reference has been entered for a health authority or license partner) on 04-Mar-2021 and was forwarded to Moderna on 04-Mar-2021. This spontaneous case was reported by a consumer and describes the occurrence of PERIPHERAL SWELLING (Swollen arm), AGITATION (felt hyper), INSOMNIA (could not sleep) and TREMOR (Hand little shaky) in a 57-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 011AZIA) for COVID-19 vaccination. No Medical History information was reported. On 03-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 03-Mar-2021, the patient experienced PERIPHERAL SWELLING (Swollen arm), AGITATION (felt hyper), INSOMNIA (could not sleep) and TREMOR (Hand little shaky). At the time of the report, PERIPHERAL SWELLING (Swollen arm), AGITATION (felt hyper), INSOMNIA (could not sleep) and TREMOR (Hand little shaky) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. The patient wanted to know if his symptoms were expected and mentioned that he was not going to take the second dose. The patient was angry and frustrated. Treatment details and concomitant medications were not reported.

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 599,999

Page last modified: 03 October 2021 5:28pm