VAERS 2021 Database www.vaers.hhs.gov

Main Page | All 2021 Deaths | Videos
VAERS Updated: 11/12/2021
** VAERS DATABASE Last updated: November 12, 2021**
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Manufacturers

Total Manufacturer
199,106MODERNA
36,710JANSSEN
5,381PFIZER\BIONTECH
2,555GLAXOSMITHKLINE BIOLOGICALS
1,469UNKNOWN MANUFACTURER
897MERCK & CO. INC.
627SEQIRUS, INC.
112DYNAVAX TECHNOLOGIES CORPORATION
91SANOFI PASTEUR
75NOVARTIS VACCINES AND DIAGNOSTICS
40EMERGENT BIOSOLUTIONS
14PAXVAX
12TEVA PHARMACEUTICALS
12PROTEIN SCIENCES CORPORATION
9PFIZER\WYETH
4BERNA BIOTECH, LTD.
4SMITHKLINE BEECHAM
3INTERCELL AG
1MEDIMMUNE VACCINES, INC.
1CSL LIMITED

COVID19 Lot Number

VAX LOT Total
2S9CL7,949
7,473
2,547
1,506
1,187
1,051
1,049
s0294561,043
866
IMM209861
816
UT7065MA766
657
579
U62828AA563
557
538
U6737AA516
515
S034636506
4F472471
458
P100253275449
444
276563436
429
418
4BH32414
MENVEO404
PP9L5362
UJ446AA337
319
306
290
271
49TM3270
R1B252M253
4F472179
933622147
C5763AA144
CW3116134
3Y7NL126
UNK114
113
ARBA141A105
104
103
96
300057A90
79
1F4EB73
R1B743M62
56
UJ090AA55
51
UH894AB46
45
UNK44
UNK42
42
EJ168638
Unknown36
35
34
32
32
26
el128424
24
A115A22
22
EN620222
21
UNK20
20
19
Z127A19
19
17
JEV18K95E15
12
111798PI12
10
A739088
No batch number8
3333324181078
6
6
TAR356
5
5
U6935AA5
UNK5
4
unknown4
3
2
55RB72
2
2
2
2
2
U7124AA2
JEV18A68E2
2
ABYB05BA1
1
1
1
1
AMVA436A1
1
1
TJ3521
A130A; VIS give1
1
U7140BB1
1
1
SP UP016AA1
1
1808P08802/ESV01
037K20A300,947
EL1284288,578
57,766
1,432

Incidents per State

State Total
82,750
CA62,821
FL38,209
TX36,512
NY34,921
PA23,646
IN23,622
IL20,597
MI19,590
OH19,426
NJ18,413
NC16,769
GA15,932
WA15,351
VA15,234
MA14,876
AZ14,206
MN12,940
MD12,656
CO11,908
WI11,425
MO10,240
TN9,685
OR8,768
KY8,437
CT8,300
SC6,700
OK6,293
AL5,692
LA5,025
IA4,825
KS4,821
UT4,637
NV4,374
NM3,967
AR3,807
ME3,161
NH3,096
NE2,918
MS2,859
ID2,785
WV2,469
HI2,459
PR2,417
MT2,414
RI2,076
DE1,868
AK1,830
VT1,734
DC1,715
ND1,388
SD1,269
WY866
GU118
VI69
AS47
MP29
MH8
XB6
FM4
QM3
XV2
XL1

ID: 1560321
Sex: F
Age: 78
State: MI

Vax Date: 02/05/2021
Onset Date: 02/07/2021
Rec V Date: 08/15/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Dysphagia, Epiglottitis

Symptoms: has raised bumps on her chest; terrible rash; burning; itching; This spontaneous case was reported by a consumer and describes the occurrence of BURNING SENSATION (burning), PRURITUS (itching), SWELLING (has raised bumps on her chest) and RASH (terrible rash) in a 78-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 038K20A) for COVID-19 vaccination. No Medical History information was reported. On 05-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 07-Feb-2021, the patient experienced BURNING SENSATION (burning), PRURITUS (itching) and RASH (terrible rash). On 03-Mar-2021, the patient experienced SWELLING (has raised bumps on her chest). At the time of the report, BURNING SENSATION (burning), PRURITUS (itching) and RASH (terrible rash) was resolving and SWELLING (has raised bumps on her chest) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Concomitant product use was not reported Treatment information was not provided

Other Meds:

Current Illness:

ID: 1560322
Sex: F
Age: 84
State:

Vax Date: 02/27/2021
Onset Date: 02/27/2021
Rec V Date: 08/15/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Anxiety, Dyspnoea

Symptoms: scab on arm; redness on arm; This spontaneous case was reported by a consumer and describes the occurrence of SCAB (scab on arm) and VACCINATION SITE ERYTHEMA (redness on arm) in an 84-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 012A21A) for COVID-19 vaccination. No Medical History information was reported. On 27-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 27-Feb-2021, the patient experienced SCAB (scab on arm) and VACCINATION SITE ERYTHEMA (redness on arm). The patient was treated with GRAMICIDIN, NEOMYCIN SULFATE, POLYMYXIN B SULFATE (NEOSPORIN [GRAMICIDIN;NEOMYCIN SULFATE;POLYMYXIN B SULFATE]) at an unspecified dose and frequency. At the time of the report, SCAB (scab on arm) and VACCINATION SITE ERYTHEMA (redness on arm) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown.

Other Meds:

Current Illness:

ID: 1560323
Sex: F
Age: 68
State: VA

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

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: EL1284
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: right arm developed a knot and had a lot of pain; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE MASS (right arm developed a knot and had a lot of pain) in a 68-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 06M20A) for COVID-19 vaccination. No Medical History information was reported. 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 VACCINATION SITE MASS (right arm developed a knot and had a lot of pain). The patient was treated with DIPHENHYDRAMINE HYDROCHLORIDE (BENADRYL [DIPHENHYDRAMINE HYDROCHLORIDE]) for Adverse event, at an unspecified dose and frequency. On 28-Feb-2021, VACCINATION SITE MASS (right arm developed a knot and had a lot of pain) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medication was reported. Treatment : Azaprocin Reporter did not allow further contact

Other Meds:

Current Illness:

ID: 1560324
Sex: M
Age: 71
State: CA

Vax Date: 02/18/2021
Onset Date: 02/25/2021
Rec V Date: 08/15/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: chills; high grade fever (T-39.9C); muscle ache; weakness; This spontaneous case was reported by a consumer and describes the occurrence of CHILLS (chills), PYREXIA (high grade fever (T-39.9C)), MYALGIA (muscle ache) and ASTHENIA (weakness) in a 71-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 024M20A) for COVID-19 vaccination. No Medical History information was reported. On 18-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 25-Feb-2021, the patient experienced CHILLS (chills), PYREXIA (high grade fever (T-39.9C)), MYALGIA (muscle ache) and ASTHENIA (weakness). On 01-Mar-2021, CHILLS (chills) and PYREXIA (high grade fever (T-39.9C)) had resolved. At the time of the report, MYALGIA (muscle ache) and ASTHENIA (weakness) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Concomitant product use was not reported Treatment information was not provided This case was linked to MOD-2021-030562 (E2B Linked Report).; Sender's Comments: MOD-2021-030562:crosslink

Other Meds:

Current Illness:

ID: 1560325
Sex: F
Age: 82
State: FL

Vax Date: 02/25/2021
Onset Date: 02/25/2021
Rec V Date: 08/15/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: A rash, it itches. about the size of a baseball. The rest of the; nauseated; tired; kinda lost the appetite; didn't have any reaction, just hurt on the arm; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (didn't have any reaction, just hurt on the arm), DECREASED APPETITE (kinda lost the appetite), RASH PRURITIC (A rash, it itches. about the size of a baseball. The rest of the), NAUSEA (nauseated) and FATIGUE (tired) in an 82-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 011A21A) for COVID-19 vaccination. No Medical History information was reported. On 25-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 25-Feb-2021, the patient experienced PAIN IN EXTREMITY (didn't have any reaction, just hurt on the arm). On 26-Feb-2021, the patient experienced DECREASED APPETITE (kinda lost the appetite), NAUSEA (nauseated) and FATIGUE (tired). On 01-Mar-2021, the patient experienced RASH PRURITIC (A rash, it itches. about the size of a baseball. The rest of the). The patient was treated with DIPHENHYDRAMINE HYDROCHLORIDE (BENADRYL [DIPHENHYDRAMINE HYDROCHLORIDE]) on 26-Feb-2021 at a dose of 1 dosage form. At the time of the report, PAIN IN EXTREMITY (didn't have any reaction, just hurt on the arm), DECREASED APPETITE (kinda lost the appetite), RASH PRURITIC (A rash, it itches. about the size of a baseball. The rest of the), NAUSEA (nauseated) and FATIGUE (tired) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant drugs were reported. Most recent FOLLOW-UP information incorporated above includes: On 17-Jun-2021: Follow up received on 17-JUNE-2021 and does not contain any new information

Other Meds:

Current Illness:

ID: 1560326
Sex: F
Age:
State: CO

Vax Date: 01/29/2021
Onset Date: 02/26/2021
Rec V Date: 08/15/2021
Hospital:

Vax Type: FLUC4
Manufacturer: SEQIRUS, INC.
Vax Name: INFLUENZA (SEASONAL) (FLUCELVAX QUADRIVALENT)
Lot: 276563
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Sore arm; Headache; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (Sore arm) and HEADACHE (Headache) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 010A21A and 007M20A) for COVID-19 vaccination. No Medical History information was reported. On 29-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 26-Feb-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 26-Feb-2021, the patient experienced PAIN IN EXTREMITY (Sore arm). 26-Feb-2021, the patient experienced HEADACHE (Headache). At the time of the report, PAIN IN EXTREMITY (Sore arm) outcome was unknown and HEADACHE (Headache) had resolved. No concomitant medications provided. No treatment information provided. Upon internal review on 21-May-2021, the age was corrected to unknown. This case was linked to MOD-2021-028429 (Patient Link). Most recent FOLLOW-UP information incorporated above includes: On 29-Apr-2021: Report received. Unknown. On 05-Jul-2021: Report received. Unknown provided pertinent to the case, requested to not to call again.

Other Meds:

Current Illness:

ID: 1560327
Sex: M
Age: 76
State: CA

Vax Date: 02/26/2021
Onset Date: 02/27/2021
Rec V Date: 08/15/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Black stool; chills; nauseous; fever; This spontaneous case was reported by a consumer and describes the occurrence of CHILLS (chills), NAUSEA (nauseous), PYREXIA (fever) and FAECES DISCOLOURED (Black stool) in a 76-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 013A21A) for COVID-19 vaccination. No Medical History information was reported. On 26-Feb-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 2 dosage form. On 27-Feb-2021, the patient experienced CHILLS (chills), NAUSEA (nauseous) and PYREXIA (fever). On 28-Feb-2021, the patient experienced FAECES DISCOLOURED (Black stool). On 01-Mar-2021, FAECES DISCOLOURED (Black stool) had resolved. At the time of the report, CHILLS (chills), NAUSEA (nauseous) and PYREXIA (fever) outcome was unknown. Concomitant product use was not reported Treatment information was not provided Reporter did not allow further contact

Other Meds:

Current Illness:

ID: 1560328
Sex: M
Age: 70
State:

Vax Date: 02/22/2021
Onset Date: 02/22/2021
Rec V Date: 08/15/2021
Hospital:

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

Lab Data: Test Date: 20211119; Test Name: SARS-CoV-2 test; Test Result: Positive ; Result Unstructured Data: positive

Allergies:

Symptom List: Pharyngeal swelling

Symptoms: Intense body aches; Muscles were rigid; Fever and severe headaches; Fever and severe headaches; Covid-19 like symptoms; Laid up for 36 hours; This spontaneous case was reported by a physician and describes the occurrence of MYALGIA (Intense body aches), MUSCLE RIGIDITY (Muscles were rigid), PYREXIA (Fever and severe headaches), HEADACHE (Fever and severe headaches) and COVID-19 (Covid-19 like symptoms) in a 70-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 024M20A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 22-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 22-Feb-2021, the patient experienced MYALGIA (Intense body aches), MUSCLE RIGIDITY (Muscles were rigid), PYREXIA (Fever and severe headaches), HEADACHE (Fever and severe headaches), COVID-19 (Covid-19 like symptoms) and SOMNOLENCE (Laid up for 36 hours). On 24-Feb-2021, MYALGIA (Intense body aches), MUSCLE RIGIDITY (Muscles were rigid), PYREXIA (Fever and severe headaches), HEADACHE (Fever and severe headaches), COVID-19 (Covid-19 like symptoms) and SOMNOLENCE (Laid up for 36 hours) had resolved. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 19-Nov-2021, SARS-CoV-2 test: positive (Positive) positive. 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. Lab test : IgG antibody test - positive Concomitant product use was not reported Treatment information was not provided

Other Meds:

Current Illness:

ID: 1560329
Sex: F
Age: 87
State: FL

Vax Date: 02/18/2021
Onset Date: 02/19/2021
Rec V Date: 08/15/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: couldn't move right arm/ couldn't use right arm/ unable to use her right arm for two days; ongoing severe pain/ excruciating pain/ like someone was "stabbing" her in her right arm; flu-like symptoms; severe pain right arm/ severe pain right forearm/ throbbing right arm/ throbbing right forearm; "horrible sensation"; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (severe pain right arm/ severe pain right forearm/ throbbing right arm/ throbbing right forearm), SENSORY DISTURBANCE ("horrible sensation"), MOBILITY DECREASED (couldn't move right arm/ couldn't use right arm/ unable to use her right arm for two days), PAIN (ongoing severe pain/ excruciating pain/ like someone was "stabbing" her in her right arm) and INFLUENZA LIKE ILLNESS (flu-like symptoms) in an 87-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 013M20A) for COVID-19 vaccination. The patient's past medical history included Pain. Concurrent medical conditions included Hypertension (Hypertension) since 2003, Rheumatoid arthritis (Rheumatoid arthritis) since 2003 and Hypothyroidism since 2003. Concomitant products included LEVOTHYROXINE SODIUM (SYNTHROID), HYDROXYCHLOROQUINE, TRAMADOL, CARVEDILOL and LOSARTAN for an unknown indication. On 18-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 19-Feb-2021, the patient experienced PAIN IN EXTREMITY (severe pain right arm/ severe pain right forearm/ throbbing right arm/ throbbing right forearm), SENSORY DISTURBANCE ("horrible sensation"), PAIN (ongoing severe pain/ excruciating pain/ like someone was "stabbing" her in her right arm) and INFLUENZA LIKE ILLNESS (flu-like symptoms). On an unknown date, the patient experienced MOBILITY DECREASED (couldn't move right arm/ couldn't use right arm/ unable to use her right arm for two days). The patient was treated with PARACETAMOL (TYLENOL) for Adverse event, at an unspecified dose and frequency and PREDNISONE ongoing since an unknown date for Adverse event, at an unspecified dose and frequency. On 22-Feb-2021, PAIN IN EXTREMITY (severe pain right arm/ severe pain right forearm/ throbbing right arm/ throbbing right forearm), SENSORY DISTURBANCE ("horrible sensation"), MOBILITY DECREASED (couldn't move right arm/ couldn't use right arm/ unable to use her right arm for two days), PAIN (ongoing severe pain/ excruciating pain/ like someone was "stabbing" her in her right arm) and INFLUENZA LIKE ILLNESS (flu-like symptoms) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown.

Other Meds: SYNTHROID; HYDROXYCHLOROQUINE; TRAMADOL; CARVEDILOL; LOSARTAN

Current Illness: Hypertension (Hypertension); Hypothyroidism; Rheumatoid arthritis (Rheumatoid arthritis)

ID: 1560330
Sex: F
Age: 74
State: MN

Vax Date: 02/25/2021
Onset Date: 02/26/2021
Rec V Date: 08/15/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Very Achy; This spontaneous case was reported by a consumer and describes the occurrence of MYALGIA (Very Achy) in a 74-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 011L20A) for COVID-19 vaccination. The patient's past medical history included COVID-19 (Had this in September 2020.). On 25-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 MYALGIA (Very Achy). On 27-Feb-2021, MYALGIA (Very Achy) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Concomitant product use was not reported. Treatment information was not provided.

Other Meds:

Current Illness:

ID: 1560331
Sex: F
Age:
State: VA

Vax Date: 02/28/2021
Onset Date: 03/01/2021
Rec V Date: 08/15/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Itchy rash on stomach; This spontaneous case was reported by a consumer and describes the occurrence of RASH PRURITIC (Itchy rash on stomach) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 027A21A) for COVID-19 vaccination. No Medical History information was reported. On 28-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 01-Mar-2021, the patient experienced RASH PRURITIC (Itchy rash on stomach). The patient was treated with DIPHENHYDRAMINE HYDROCHLORIDE (BENADRYL [DIPHENHYDRAMINE HYDROCHLORIDE]) for Adverse event, at an unspecified dose and frequency. At the time of the report, RASH PRURITIC (Itchy rash on stomach) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Concomitant product use was not reported

Other Meds:

Current Illness:

ID: 1560332
Sex: F
Age:
State: PA

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

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

Lab Data:

Allergies:

Symptom List: Rash, Urticaria

Symptoms: Sore arm; Confusion in head that lasted couple hours; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (Sore arm) and CONFUSIONAL STATE (Confusion in head that lasted couple hours) in a 66-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 030L20A) for COVID-19 vaccination. Concomitant products included REPAGLINIDE for Product used for unknown indication, QUINAPRIL, LEVOTHYROXINE, CLOPIDOGREL, ATORVASTATIN, OXYCODONE, GLIMEPIRIDE, METFORMIN, COLESEVELAM HYDROCHLORIDE (WELCHOL), MIRABEGRON (MYRBETRIQ), LORATADINE, FLUTICASONE, ALCLOMETASONE, ACETYLSALICYLIC ACID (ASPIRIN LOW), MULTIVITAMINS [VITAMINS NOS], UBIDECARENONE (COQ), BIOTIN, ZINC, VITAMIN D3 and VITAMIN C [ASCORBIC ACID] for an unknown indication. 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 PAIN IN EXTREMITY (Sore arm) and CONFUSIONAL STATE (Confusion in head that lasted couple hours). At the time of the report, PAIN IN EXTREMITY (Sore arm) and CONFUSIONAL STATE (Confusion in head that lasted couple hours) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Treatment information was not provided.

Other Meds: QUINAPRIL; LEVOTHYROXINE; CLOPIDOGREL; ATORVASTATIN; OXYCODONE; GLIMEPIRIDE; METFORMIN; WELCHOL; REPAGLINIDE; MYRBETRIQ; LORATADINE; FLUTICASONE; ALCLOMETASONE; ASPIRIN LOW; MULTIVITAMINS [VITAMINS NOS]; COQ; BIOTIN; ZINC; VITAMIN D3; VITAM

Current Illness:

ID: 1560333
Sex: M
Age: 76
State: IN

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

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

Lab Data:

Allergies:

Symptom List: Blood pressure decreased, Chest pain, Chills, Confusional state, Decreased appetite

Symptoms: stiff neck; sore arm; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (sore arm) and MUSCULOSKELETAL STIFFNESS (stiff neck) in a 76-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 006M20A) for COVID-19 vaccination. Concurrent medical conditions included Diabetes and High cholesterol. Concomitant products included ACETYLSALICYLIC ACID (BABY ASPIRIN), GLIMEPIRIDE, METOPROLOL, METFORMIN, OMEPRAZOLE and ROSUVASTATIN for an unknown indication. On 19-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 19-Feb-2021, the patient experienced PAIN IN EXTREMITY (sore arm). On 20-Feb-2021, the patient experienced MUSCULOSKELETAL STIFFNESS (stiff neck). At the time of the report, PAIN IN EXTREMITY (sore arm) outcome was unknown and MUSCULOSKELETAL STIFFNESS (stiff neck) had not resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. HCP told patient to use hot and cold compress and Tylenol.

Other Meds: BABY ASPIRIN; GLIMEPIRIDE; METOPROLOL; METFORMIN; OMEPRAZOLE; ROSUVASTATIN

Current Illness:

ID: 1560334
Sex: F
Age: 89
State: NY

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

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025J20-2A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: tenderness in right arm for two days; This spontaneous case was reported by a consumer and describes the occurrence of TENDERNESS (tenderness in right arm for two days) in an 89-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 030M20A) for COVID-19 vaccination. Concurrent medical conditions included Arthritis. Concomitant products included PARACETAMOL (TYLENOL) for Arthritis, AMLODIPINE, ACETYLSALICYLIC ACID (BABY ASPIRIN), CALCIUM, UBIDECARENONE (COQ), FISH OIL, GLUCOSE, SODIUM CHLORIDE, SODIUM LACTATE (LACTATE 1 2 3), MAGNESIUM, SIMVASTATIN and LEVOTHYROXINE SODIUM (THYROXIN) for an unknown indication. On 10-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 10-Feb-2021, the patient experienced TENDERNESS (tenderness in right arm for two days). On 12-Feb-2021, TENDERNESS (tenderness in right arm for two days) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No treatment medication was reported. This case was linked to MOD-2021-097147 (Patient Link). Most recent FOLLOW-UP information incorporated above includes: On 29-Apr-2021: Information about first dose event outcome and second dose events.

Other Meds: AMLODIPINE; BABY ASPIRIN; CALCIUM; COQ; FISH OIL; LACTATE 1 2 3; MAGNESIUM; SIMVASTATIN; THYROXIN; TYLENOL

Current Illness:

ID: 1560335
Sex: F
Age: 85
State: IL

Vax Date: 02/27/2021
Onset Date: 02/27/2021
Rec V Date: 08/15/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Adverse drug reaction; Weird sensation; Arm was very heavy like rubber bands were around it tight; Painful; Hands were icy cold; This spontaneous case was reported by a consumer and describes the occurrence of ADVERSE DRUG REACTION (Adverse drug reaction), FEELING ABNORMAL (Weird sensation), LIMB DISCOMFORT (Arm was very heavy like rubber bands were around it tight), PAIN IN EXTREMITY (Painful) and PERIPHERAL COLDNESS (Hands were icy cold) in an 85-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 010AZ1A) for COVID-19 vaccination. No Medical History information was reported. On 27-Feb-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 2 dosage form. On 27-Feb-2021, the patient experienced ADVERSE DRUG REACTION (Adverse drug reaction), FEELING ABNORMAL (Weird sensation), LIMB DISCOMFORT (Arm was very heavy like rubber bands were around it tight), PAIN IN EXTREMITY (Painful) and PERIPHERAL COLDNESS (Hands were icy cold). At the time of the report, ADVERSE DRUG REACTION (Adverse drug reaction), FEELING ABNORMAL (Weird sensation), LIMB DISCOMFORT (Arm was very heavy like rubber bands were around it tight), PAIN IN EXTREMITY (Painful) and PERIPHERAL COLDNESS (Hands were icy cold) outcome was unknown. Concomitant product use was not reported. Treatment information was not provided.

Other Meds:

Current Illness:

ID: 1560336
Sex: M
Age:
State: OR

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

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

Lab Data:

Allergies:

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

Symptoms: Developed swelling eyes; Itching; Rash; This spontaneous case was reported by a consumer and describes the occurrence of in a male patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 19-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. The patient was treated with DIPHENHYDRAMINE HYDROCHLORIDE (BENADRYL [DIPHENHYDRAMINE HYDROCHLORIDE]) for Adverse event, at an unspecified dose and frequency. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Concomitant product information was not reported. This case was linked to MOD-2021-096932 (Patient Link). Most recent FOLLOW-UP information incorporated above includes: On 29-Apr-2021

Other Meds:

Current Illness:

ID: 1560337
Sex: F
Age: 69
State: RI

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

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

Lab Data:

Allergies:

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

Symptoms: Patient started feeling jittery 24 hours later after receiving 1st dose; Patient had a sore arm; This spontaneous case was reported by a physician and describes the occurrence of FEELING JITTERY (Patient started feeling jittery 24 hours later after receiving 1st dose) and VACCINATION SITE PAIN (Patient had a sore arm) in a 69-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 012A21A) for COVID-19 vaccination. Concomitant products included ESTRADIOL (ESTROGEL) for an unknown indication. 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 VACCINATION SITE PAIN (Patient had a sore arm). On 27-Feb-2021, the patient experienced FEELING JITTERY (Patient started feeling jittery 24 hours later after receiving 1st dose). The patient was treated with PARACETAMOL (TYLENOL) for Adverse event, at an unspecified dose and frequency. At the time of the report, FEELING JITTERY (Patient started feeling jittery 24 hours later after receiving 1st dose) and VACCINATION SITE PAIN (Patient had a sore 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: ESTROGEL

Current Illness:

ID: 1560338
Sex: M
Age: 74
State: MA

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

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

Lab Data:

Allergies:

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Sore upper arm; A spontaneous report was received from a consumer concerning a 74-years-old male patient who received first dose of Moderna's COVID-19 vaccine (mRNA-1273) and experienced events sore upper arm/pain in extremity. The patient's medical history included allergy to ibuprofen. Concomitant medications reported were men`s multivitamin, vitamin D3, cholesterol pill, medicine for liver and acid reflux pill. On 19 Feb 2021, prior to the onset of the events the patient received first of two planned doses of mRNA-1273 (lot/batch: 030M20A) intramuscularly in the right deltoid for prophylaxis of COVID-19 infection.On 19 Feb 2021, the patient experienced sore in upper arm.No treatment was taken by the patient. Action taken with mRNA-1273 in response to the events was unknown. The outcome of event sore upper arm was unknown.

Other Meds: MULTIVITAMIN ACTIVE MAN; VITAMIN D 3

Current Illness: Drug allergy (Allergic to Benadryl.)

ID: 1560339
Sex: M
Age: 83
State:

Vax Date: 02/22/2021
Onset Date: 02/24/2021
Rec V Date: 08/15/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: whole head felt like it was on fire; Groggy; Dizzy; This spontaneous case was reported by a consumer and describes the occurrence of HEADACHE (whole head felt like it was on fire), SOMNOLENCE (Groggy) and DIZZINESS (Dizzy) in an 83-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 22-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 24-Feb-2021, the patient experienced HEADACHE (whole head felt like it was on fire), SOMNOLENCE (Groggy) and DIZZINESS (Dizzy). At the time of the report, HEADACHE (whole head felt like it was on fire), SOMNOLENCE (Groggy) and DIZZINESS (Dizzy) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Concomitant product use was not reported. Treatment information was not provided.

Other Meds:

Current Illness:

ID: 1560340
Sex: F
Age: 73
State: ID

Vax Date: 02/25/2021
Onset Date: 02/25/2021
Rec V Date: 08/15/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Left arm tingling; Left hand fingers tingling; left side of face swollen; left sides of glands swollen; feeling tired; This spontaneous case was reported by a consumer and describes the occurrence of INJECTION SITE PARAESTHESIA (Left arm tingling), PARAESTHESIA (Left hand fingers tingling), SWELLING FACE (left side of face swollen), LYMPHADENOPATHY (left sides of glands swollen) and FATIGUE (feeling tired) in a 73-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 011A21A) for COVID-19 vaccination. No Medical History information was reported. On 25-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 25-Feb-2021, the patient experienced INJECTION SITE PARAESTHESIA (Left arm tingling), PARAESTHESIA (Left hand fingers tingling), SWELLING FACE (left side of face swollen), LYMPHADENOPATHY (left sides of glands swollen) and FATIGUE (feeling tired). The patient was treated with PARACETAMOL (TYLENOL) at a dose of 1 dosage form; COLECALCIFEROL (VITAMIN D [COLECALCIFEROL]) ongoing since an unknown date at a dose of UNK dosage form; AMINO ACIDS NOS ongoing since an unknown date at a dose of UNK dosage form and TURMERIC [CURCUMA LONGA RHIZOME] ongoing since an unknown date at a dose of UNK dosage form. On 01-Mar-2021, LYMPHADENOPATHY (left sides of glands swollen) had resolved. At the time of the report, INJECTION SITE PARAESTHESIA (Left arm tingling), PARAESTHESIA (Left hand fingers tingling), SWELLING FACE (left side of face swollen) and FATIGUE (feeling tired) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Patient's treatment medications included unspecified vitamins.

Other Meds:

Current Illness:

ID: 1560341
Sex: F
Age: 72
State: CA

Vax Date: 02/09/2021
Onset Date: 02/01/2021
Rec V Date: 08/15/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: feeling like needles or puncturing 3 inches below the injection site, not sure if the bone or muscle; pain in the neck on the left side and in the lymph nodes; head ache on the left side; redness on the injection site; pain in the neck on the left side and in the lymph nodes; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE REACTION (feeling like needles or puncturing 3 inches below the injection site, not sure if the bone or muscle), NECK PAIN (pain in the neck on the left side and in the lymph nodes), HEADACHE (head ache on the left side), VACCINATION SITE ERYTHEMA (redness on the injection site) and LYMPH NODE PAIN (pain in the neck on the left side and in the lymph nodes) in a 72-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 030L20A) 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) (Intramuscular) 1 dosage form. In February 2021, the patient experienced NECK PAIN (pain in the neck on the left side and in the lymph nodes), HEADACHE (head ache on the left side), VACCINATION SITE ERYTHEMA (redness on the injection site) and LYMPH NODE PAIN (pain in the neck on the left side and in the lymph nodes). On 01-Mar-2021, the patient experienced VACCINATION SITE REACTION (feeling like needles or puncturing 3 inches below the injection site, not sure if the bone or muscle). At the time of the report, VACCINATION SITE REACTION (feeling like needles or puncturing 3 inches below the injection site, not sure if the bone or muscle), HEADACHE (head ache on the left side) and VACCINATION SITE ERYTHEMA (redness on the injection site) outcome was unknown and NECK PAIN (pain in the neck on the left side and in the lymph nodes) and LYMPH NODE PAIN (pain in the neck on the left side and in the lymph nodes) had not resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medications reported. Patient did not receive any treatment medications for the symptoms.

Other Meds:

Current Illness:

ID: 1560342
Sex: F
Age: 69
State: AZ

Vax Date: 03/01/2021
Onset Date: 03/02/2021
Rec V Date: 08/15/2021
Hospital:

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

Lab Data: Test Date: 20210302; Test Name: body temperature; Result Unstructured Data: Patient's body temperature was 101 F

Allergies:

Symptom List: Unevaluable event

Symptoms: Clogged Ears; Sore Left Arm; Sore Throat; Diarrhea; Chills; Fever 101 F; This spontaneous case was reported by a consumer and describes the occurrence of EUSTACHIAN TUBE DYSFUNCTION (Clogged Ears), PERIPHERAL SWELLING (Sore Left Arm), OROPHARYNGEAL PAIN (Sore Throat), DIARRHOEA (Diarrhea) and CHILLS (Chills) in a 69-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. No Medical History information was reported. On 01-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 02-Mar-2021, the patient experienced EUSTACHIAN TUBE DYSFUNCTION (Clogged Ears), PERIPHERAL SWELLING (Sore Left Arm), OROPHARYNGEAL PAIN (Sore Throat), DIARRHOEA (Diarrhea), CHILLS (Chills) and PYREXIA (Fever 101 F). At the time of the report, EUSTACHIAN TUBE DYSFUNCTION (Clogged Ears), PERIPHERAL SWELLING (Sore Left Arm), OROPHARYNGEAL PAIN (Sore Throat), DIARRHOEA (Diarrhea), CHILLS (Chills) and PYREXIA (Fever 101 F) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 02-Mar-2021, Body temperature: 101 (High) Patient's body temperature was 101 F. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant and treatment medication information was reported. Most recent FOLLOW-UP information incorporated above includes: On 16-Jul-2021: TCR received: updated reporter's address

Other Meds:

Current Illness:

ID: 1560343
Sex: F
Age: 71
State: NJ

Vax Date: 02/23/2021
Onset Date: 02/01/2021
Rec V Date: 08/15/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: hives on body, in various spots; itching; This spontaneous case was reported by a consumer (subsequently medically confirmed) and describes the occurrence of URTICARIA (hives on body, in various spots) and PRURITUS (itching) in a 71-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 001A21A) for COVID-19 vaccination. No medical history was provided by the reporter. Concomitant products included ASCORBIC ACID, TOCOPHERYL ACETATE, XANTOFYL, ZEAXANTHIN, ZINC (AREDS) for an unknown indication. On 23-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. In February 2021, the patient experienced PRURITUS (itching). On 25-Feb-2021, the patient experienced URTICARIA (hives on body, in various spots). The patient was treated with LORATADINE, PSEUDOEPHEDRINE HYDROCHLORIDE (BENADRYL 24 D) in February 2021 for Itching, at an unspecified dose and frequency. At the time of the report, URTICARIA (hives on body, in various spots) had not resolved and PRURITUS (itching) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Patient's concomitant medications included unspecified cholesterol medicines, blood pressure medicines and hormone replacement medicines. Patient used unspecified cream on the spots as treatment.

Other Meds: AREDS

Current Illness:

ID: 1560344
Sex: F
Age: 38
State: CA

Vax Date: 02/19/2021
Onset Date: 02/25/2021
Rec V Date: 08/15/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Injection site pain, Pain

Symptoms: Crotch pain; Red Lump on arm; Hot lump on arm; Pain in arm; Collarbone pain; Lump on collarbone; Pain in armpit; Red lump on arm; Lump in armpit; Low grade fever; This spontaneous case was reported by a consumer and describes the occurrence of AXILLARY MASS (Lump in armpit), GROIN PAIN (Crotch pain), VACCINATION SITE MASS (Red Lump on arm), VACCINATION SITE WARMTH (Hot lump on arm) and PAIN IN EXTREMITY (Pain in arm) in a 38-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 042L20A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 19-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 25-Feb-2021, the patient experienced PYREXIA (Low grade fever). On 27-Feb-2021, the patient experienced AXILLARY MASS (Lump in armpit). On 28-Feb-2021, the patient experienced GROIN PAIN (Crotch pain), VACCINATION SITE MASS (Red Lump on arm), VACCINATION SITE WARMTH (Hot lump on arm), PAIN IN EXTREMITY (Pain in arm), BONE PAIN (Collarbone pain), MASS (Lump on collarbone), AXILLARY PAIN (Pain in armpit) and VACCINATION SITE ERYTHEMA (Red lump on arm). At the time of the report, AXILLARY MASS (Lump in armpit), GROIN PAIN (Crotch pain), VACCINATION SITE MASS (Red Lump on arm), VACCINATION SITE WARMTH (Hot lump on arm), PAIN IN EXTREMITY (Pain in arm), BONE PAIN (Collarbone pain), MASS (Lump on collarbone), AXILLARY PAIN (Pain in armpit), VACCINATION SITE ERYTHEMA (Red lump on arm) and PYREXIA (Low grade fever) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Concomitant product use was not provided by the reporter. Treatment of the events included aspirin This case was linked to MOD-2021-099036 (Patient Link). Most recent FOLLOW-UP information incorporated above includes: On 29-Apr-2021: Follow-up was received and outcome of the events, email address of reporter were updated

Other Meds:

Current Illness:

ID: 1560345
Sex: F
Age: 76
State: CA

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

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

Lab Data:

Allergies:

Symptom List: Injection site pain, Menorrhagia

Symptoms: chills; feverish; joint pain; muscle pain; A spontaneous report was received from a consumer concerning a 76-years-old patient who received Moderna's COVID-19 vaccine (mRNA-1273) and experienced events chills, feverish, joint pain, muscle pain. The patient's medical history was not provided. No relevant concomitant medications were reported. On 1 Mar 2021, prior to the onset of the events the patient received first of two planned doses of mRNA-1273 (lot/batch: 13M20A) intramuscularly in the right arm for prophylaxis of COVID-19 infection. On an unknown date, the patient experienced the event(s) chills, feverish, joint pain, muscle pain. Treatment details included Tylenol. Action taken with mRNA-1273 in response to the events was not reported. The outcome of event(s), chills, feverish, joint pain, muscle pain was unknown.

Other Meds:

Current Illness:

ID: 1560346
Sex: F
Age: 76
State: FL

Vax Date: 02/26/2021
Onset Date: 02/27/2021
Rec V Date: 08/15/2021
Hospital:

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

Lab Data: Test Date: 20210227; Test Name: body temperature; Result Unstructured Data: fever; Test Date: 20210228; Test Name: body temperature; Result Unstructured Data: fever

Allergies:

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

Symptoms: fatigue; arm cherry red; arm swollen down to elbow; arm hot; arm itching; nausea; teeth chattering chills; fever; body aches; head aches; This spontaneous case was reported by a nurse and describes the occurrence of INJECTION SITE REACTION (arm swollen down to elbow), VACCINATION SITE WARMTH (arm hot), PRURITUS (arm itching), NAUSEA (nausea) and CHILLS (teeth chattering chills) in a 76-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 011A21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 26-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 27-Feb-2021, the patient experienced INJECTION SITE REACTION (arm swollen down to elbow), VACCINATION SITE WARMTH (arm hot), PRURITUS (arm itching), NAUSEA (nausea), CHILLS (teeth chattering chills), PYREXIA (fever), MYALGIA (body aches), HEADACHE (head aches) and INJECTION SITE ERYTHEMA (arm cherry red). On 28-Feb-2021, the patient experienced FATIGUE (fatigue). The patient was treated with PARACETAMOL (TYLENOL) on 27-Feb-2021 for Fever, at a dose of 650 milligram and METHYLPREDNISOLONE ACETATE (MEDROL [METHYLPREDNISOLONE ACETATE]) for Adverse reaction, at a dose of 4 milligram twice a day. On 27-Feb-2021, NAUSEA (nausea) had resolved. At the time of the report, INJECTION SITE REACTION (arm swollen down to elbow), VACCINATION SITE WARMTH (arm hot), PRURITUS (arm itching), CHILLS (teeth chattering chills), PYREXIA (fever), MYALGIA (body aches), HEADACHE (head aches), FATIGUE (fatigue) and INJECTION SITE ERYTHEMA (arm cherry red) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 27-Feb-2021, Body temperature: 102.5 deg f (High) fever. On 28-Feb-2021, Body temperature: 105.5 deg f (High) fever. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No concomitant medications reported.

Other Meds:

Current Illness:

ID: 1560347
Sex: F
Age: 65
State: NJ

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

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

Lab Data:

Allergies:

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Chest tightness; Bone pain; Ear pain; Pain in the face; Neck pain; Diarrhea; Fever; This spontaneous case was reported by a consumer and describes the occurrence of CHEST DISCOMFORT (Chest tightness), BONE PAIN (Bone pain), EAR PAIN (Ear pain), FACIAL PAIN (Pain in the face) and NECK PAIN (Neck pain) in a 65-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 022M20A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. 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 CHEST DISCOMFORT (Chest tightness), BONE PAIN (Bone pain), EAR PAIN (Ear pain), FACIAL PAIN (Pain in the face), NECK PAIN (Neck pain), DIARRHOEA (Diarrhea) and PYREXIA (Fever). The patient was treated with PARACETAMOL (TYLENOL) in February 2021 for Adverse reaction, at an unspecified dose and frequency. On 01-Mar-2021, CHEST DISCOMFORT (Chest tightness), BONE PAIN (Bone pain), EAR PAIN (Ear pain), FACIAL PAIN (Pain in the face), NECK PAIN (Neck pain), DIARRHOEA (Diarrhea) and PYREXIA (Fever) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medications were reported. Most recent FOLLOW-UP information incorporated above includes: On 30-Apr-2021: Follow-up received and reporter contact information was updated.

Other Meds:

Current Illness:

ID: 1560348
Sex: M
Age:
State:

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

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

Lab Data:

Allergies:

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: experiencing some side effects; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION COMPLICATION (experiencing some side effects) in a male 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 dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced VACCINATION COMPLICATION (experiencing some side effects). At the time of the report, VACCINATION COMPLICATION (experiencing some side effects) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant medication was reported. No treatment information was provided.

Other Meds:

Current Illness:

ID: 1560349
Sex: F
Age: 79
State: OH

Vax Date: 02/07/2021
Onset Date: 02/07/2021
Rec V Date: 08/15/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Burning sensation from the injection site down to her elbow; Not feeling well in general; Soreness; Fatigue; Headache; This spontaneous case was reported by a consumer and describes the occurrence of BURNING SENSATION (Burning sensation from the injection site down to her elbow), MALAISE (Not feeling well in general), PAIN (Soreness), FATIGUE (Fatigue) and HEADACHE (Headache) in a 79-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 007M20A) for COVID-19 vaccination. Concurrent medical conditions included Arthritis, Hypertension and Cholesterol. On 07-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 07-Feb-2021, the patient experienced BURNING SENSATION (Burning sensation from the injection site down to her elbow), MALAISE (Not feeling well in general), PAIN (Soreness), FATIGUE (Fatigue) and HEADACHE (Headache). The patient was treated with PARACETAMOL (TYLENOL) ongoing since an unknown date for Arthritis, at a dose of UNK dosage form and DIURETICS for Hypertension, at an unspecified dose and frequency. On 10-Feb-2021, MALAISE (Not feeling well in general), FATIGUE (Fatigue) and HEADACHE (Headache) had resolved. At the time of the report, BURNING SENSATION (Burning sensation from the injection site down to her elbow) and PAIN (Soreness) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. This case was linked to MOD-2021-099179 (Patient Link). Most recent FOLLOW-UP information incorporated above includes: On 29-Apr-2021: Patient Email address was not provided.

Other Meds:

Current Illness: Arthritis; Cholesterol; Hypertension

ID: 1560350
Sex: F
Age: 53
State: MA

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

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

Lab Data:

Allergies:

Symptom List: Nausea

Symptoms: persistent tingling in her right foot, toes, and ankle; lips were feeling dry and tingling; lips were feeling dry and tingling; This spontaneous case was reported by a consumer and describes the occurrence of PARAESTHESIA (persistent tingling in her right foot, toes, and ankle), LIP DRY (lips were feeling dry and tingling) and PARAESTHESIA ORAL (lips were feeling dry and tingling) in a 53-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 010A21A) for COVID-19 vaccination. Concurrent medical conditions included Penicillin allergy (rash and hives), Drug allergy (welbutrin: rash and hives) and Menopause (experiencing hot flashes and chills). Concomitant products included MULTIVITAMINS [VITAMINS NOS] for an unknown indication. On 01-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 01-Mar-2021, the patient experienced PARAESTHESIA (persistent tingling in her right foot, toes, and ankle), LIP DRY (lips were feeling dry and tingling) and PARAESTHESIA ORAL (lips were feeling dry and tingling). At the time of the report, PARAESTHESIA (persistent tingling in her right foot, toes, and ankle), LIP DRY (lips were feeling dry and tingling) and PARAESTHESIA ORAL (lips were feeling dry and tingling) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Patient applied Vaseline for the event lips were feeling dry and tingling, and felt better at the time of report.

Other Meds: MULTIVITAMINS [VITAMINS NOS]

Current Illness: Menopause (experiencing hot flashes and chills); Penicillin allergy (rash and hives)

ID: 1560351
Sex: F
Age: 72
State: WA

Vax Date: 02/04/2021
Onset Date: 02/14/2021
Rec V Date: 08/15/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Injection site pain

Symptoms: low grade fever; diagnosed with shingles; skin pain; pain at the injection site; red rash around the injection site; This spontaneous case was reported by a consumer and describes the occurrence of HERPES ZOSTER (diagnosed with shingles), PAIN OF SKIN (skin pain), VACCINATION SITE PAIN (pain at the injection site), VACCINATION SITE RASH (red rash around the injection site) and PYREXIA (low grade fever) in a 72-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 013M20A) for COVID-19 vaccination. No medical history was provided by the reporter. Concomitant products included GABAPENTIN, LEVOTHYROXINE, PANTOPRAZOLE, LAMOTRIGINE, ACETYLSALICYLIC ACID (ASPIRIN CUPAL [ACETYLSALICYLIC ACID]) and PAROXETINE 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 14-Feb-2021, the patient experienced VACCINATION SITE PAIN (pain at the injection site) and VACCINATION SITE RASH (red rash around the injection site). On 15-Feb-2021, the patient experienced PAIN OF SKIN (skin pain). On 18-Feb-2021, the patient experienced HERPES ZOSTER (diagnosed with shingles). On 23-Feb-2021, the patient experienced PYREXIA (low grade fever). The patient was treated with ACETAMINOPHEN in February 2021 for Adverse reaction, at an unspecified dose and frequency. On 25-Feb-2021, PYREXIA (low grade fever) had resolved. At the time of the report, HERPES ZOSTER (diagnosed with shingles), PAIN OF SKIN (skin pain), VACCINATION SITE PAIN (pain at the injection site) and VACCINATION SITE RASH (red rash around 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. It was also reported that the shingles appeared on the same side of the body where the vaccine was administered. Patient was treated with unspecified antiviral medication for Shingles starting on 19-FEB-2021.

Other Meds: GABAPENTIN; LEVOTHYROXINE; PANTOPRAZOLE; LAMOTRIGINE; ASPIRIN CUPAL [ACETYLSALICYLIC ACID]; PAROXETINE

Current Illness:

ID: 1560352
Sex: F
Age: 66
State: TN

Vax Date: 02/26/2021
Onset Date: 02/28/2021
Rec V Date: 08/15/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Abdominal cramps; Sweating; headache; nausea; fatigue; This spontaneous case was reported by a consumer and describes the occurrence of ABDOMINAL PAIN (Abdominal cramps), HYPERHIDROSIS (Sweating), HEADACHE (headache), NAUSEA (nausea) and FATIGUE (fatigue) in a 66-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 010A21A) for COVID-19 vaccination. No Medical History information was reported. On 26-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 28-Feb-2021, the patient experienced ABDOMINAL PAIN (Abdominal cramps), HYPERHIDROSIS (Sweating), HEADACHE (headache), NAUSEA (nausea) and FATIGUE (fatigue). On 02-Mar-2021, ABDOMINAL PAIN (Abdominal cramps), HYPERHIDROSIS (Sweating), HEADACHE (headache), NAUSEA (nausea) and FATIGUE (fatigue) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant and treatment drugs were reported.

Other Meds:

Current Illness:

ID: 1560353
Sex: F
Age: 37
State: IL

Vax Date: 02/21/2021
Onset Date: 02/21/2021
Rec V Date: 08/15/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Injection arm going to sleep; Itchiness at the injection site; redness at the injection site; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION COMPLICATION (Injection arm going to sleep), VACCINATION SITE PRURITUS (Itchiness at the injection site) and VACCINATION SITE ERYTHEMA (redness at the injection site) in a 37-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 21-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 21-Feb-2021, the patient experienced VACCINATION SITE PRURITUS (Itchiness at the injection site) and VACCINATION SITE ERYTHEMA (redness at the injection site). On 01-Mar-2021, the patient experienced VACCINATION COMPLICATION (Injection arm going to sleep). In February 2021, VACCINATION SITE PRURITUS (Itchiness at the injection site) and VACCINATION SITE ERYTHEMA (redness at the injection site) had resolved. At the time of the report, VACCINATION COMPLICATION (Injection arm going to sleep) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medications reported. Treatment medications was not provided by the reporter

Other Meds:

Current Illness:

ID: 1560354
Sex: M
Age: 74
State: MN

Vax Date: 02/25/2021
Onset Date: 02/26/2021
Rec V Date: 08/15/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 039K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Tremor

Symptoms: Extremely achy; This spontaneous case was reported by a consumer and describes the occurrence of PAIN (Extremely achy) in a 74-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The patient's past medical history included COVID-19. On 25-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 PAIN (Extremely achy). On 27-Feb-2021, PAIN (Extremely achy) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medications reported. Treatment medications was not provided by the reporter

Other Meds:

Current Illness:

ID: 1560355
Sex: F
Age: 75
State: OH

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

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

Lab Data:

Allergies:

Symptom List: Erythema, Pruritus

Symptoms: Rash on arm localized; Swelling; A spontaneous report was received from a consumer concerning a 75-years-old female patient who received Moderna's COVID-19 vaccine (mRNA-1273) and experienced events swelling, rash on arm localized. The patient's medical history was not provided. No relevant concomitant medications were reported. On unknown date, prior to the onset of the events the patient received first of two planned doses of mRNA-1273 (lot/batch: 013M20A) intramuscularly for prophylaxis of COVID-19 infection. On 15 Feb 2021, the patient experienced the event(s) swelling. On 28 Feb 2021, the patient experienced the event(s) rash on arm localized. Treatment details included No HCP consulted. Action taken with mRNA-1273 in response to the events was not reported. On 17 Feb 2021 the outcome of event(s), swelling was resolved. On28 Feb 2021 the outcome of event(s), rash on arm localized was resolved.

Other Meds:

Current Illness:

ID: 1560356
Sex: F
Age:
State: IL

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

Vax Type: UNK
Manufacturer: UNKNOWN MANUFACTURER
Vax Name: VACCINE NOT SPECIFIED (NO BRAND NAME)
Lot:
Dose Series: UNK
Vax Route: SYR
Vax Site: UN

Lab Data:

Allergies:

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

Symptoms: pin-prickly-like tingling on her back; hot on her arm at the injection; felt a little bit of nausea; This spontaneous case was reported by a consumer and describes the occurrence of PARAESTHESIA (pin-prickly-like tingling on her back), VACCINATION SITE WARMTH (hot on her arm at the injection) and NAUSEA (felt a little bit of nausea) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 26-Feb-2021, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On an unknown date, the patient experienced PARAESTHESIA (pin-prickly-like tingling on her back), VACCINATION SITE WARMTH (hot on her arm at the injection) and NAUSEA (felt a little bit of nausea). At the time of the report, PARAESTHESIA (pin-prickly-like tingling on her back), VACCINATION SITE WARMTH (hot on her arm at the injection) and NAUSEA (felt a little bit of nausea) outcome was unknown. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medications reported. Treatment medications was not provided by the reporter

Other Meds:

Current Illness:

ID: 1560357
Sex: F
Age: 72
State: FL

Vax Date: 01/30/2021
Onset Date: 01/30/2021
Rec V Date: 08/15/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Soreness at the injection site post first dose; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE PAIN (Soreness at the injection site post first dose) in a 72-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 030L20A) for COVID-19 vaccination. No Medical History information was reported. On 30-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 VACCINATION SITE PAIN (Soreness at the injection site post first dose). At the time of the report, VACCINATION SITE PAIN (Soreness at the injection site post first dose) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medications reported. Treatment medications was not provided by the reporter This case was linked to MOD-2021-030677.

Other Meds:

Current Illness:

ID: 1560358
Sex: F
Age:
State: OK

Vax Date: 02/23/2021
Onset Date: 02/23/2021
Rec V Date: 08/15/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 039K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: coughing up a phlegm, spitting up phlegm; body aches; headache; chills; fever; This spontaneous case was reported by a consumer and describes the occurrence of PRODUCTIVE COUGH (coughing up a phlegm, spitting up phlegm), PAIN (body aches), HEADACHE (headache), CHILLS (chills) and PYREXIA (fever) in a 90-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. D24M20A) for COVID-19 vaccination. Concurrent medical conditions included Heart disease, unspecified. On 23-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 23-Feb-2021, the patient experienced PAIN (body aches), HEADACHE (headache), CHILLS (chills) and PYREXIA (fever). On an unknown date, the patient experienced PRODUCTIVE COUGH (coughing up a phlegm, spitting up phlegm). On 26-Feb-2021, PAIN (body aches), HEADACHE (headache), CHILLS (chills) and PYREXIA (fever) had resolved. At the time of the report, PRODUCTIVE COUGH (coughing up a phlegm, spitting up phlegm) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Patient's concomitant medication included unspecified heart medication. Treatment medications was not provided by the reporter

Other Meds:

Current Illness:

ID: 1560359
Sex: U
Age:
State: IL

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

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

Lab Data:

Allergies:

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

Symptoms: urinary frequency; urinary urgency; chills; This spontaneous case was reported by a consumer and describes the occurrence of POLLAKIURIA (urinary frequency), MICTURITION URGENCY (urinary urgency) and CHILLS (chills) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 24-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 an unknown date, the patient experienced POLLAKIURIA (urinary frequency), MICTURITION URGENCY (urinary urgency) and CHILLS (chills). At the time of the report, POLLAKIURIA (urinary frequency), MICTURITION URGENCY (urinary urgency) and CHILLS (chills) outcome was unknown. No concomitant medications reported. Treatment medications was not provided by the reporter Reporter did not allow further contact

Other Meds:

Current Illness:

ID: 1560360
Sex: F
Age:
State: FL

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

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: EK9231
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: UTI; This spontaneous case was reported by a consumer and describes the occurrence of URINARY TRACT INFECTION (UTI) in a 68-year-old female patient 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 URINARY TRACT INFECTION (UTI). At the time of the report, URINARY TRACT INFECTION (UTI) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No Concomitant and treatment medications were provided. Patient has no side effects after receiving first dose of moderna vaccine. Most recent FOLLOW-UP information incorporated above includes: On 13-Jul-2021: Non significant follow up:NNI

Other Meds:

Current Illness:

ID: 1560361
Sex: F
Age: 59
State: UT

Vax Date: 01/16/2021
Onset Date: 02/22/2021
Rec V Date: 08/15/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Pain in extremity

Symptoms: Dizziness when laying down, and sitting up; headaches; chills; body aches; in the fog; This spontaneous case was reported by a consumer and describes the occurrence of PAIN (body aches), FEELING ABNORMAL (in the fog), DIZZINESS (Dizziness when laying down, and sitting up), HEADACHE (headaches) and CHILLS (chills) in a 59-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 041L20A) for COVID-19 vaccination. No medical history was reported. Concomitant products included CALCIUM from 01-Jan-2013 to an unknown date for Calcium supplementation, MAGNESIUM from 01-Jan-2013 to an unknown date for Magnesium supplementation, COLECALCIFEROL (VITAMIN D [COLECALCIFEROL]) from 01-Jan-2013 to an unknown date for Supplementation therapy, ZINC from 01-Jan-2013 to an unknown date for Zinc supplementation. On 16-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 22-Feb-2021, the patient experienced DIZZINESS (Dizziness when laying down, and sitting up). On an unknown date, the patient experienced PAIN (body aches), FEELING ABNORMAL (in the fog), HEADACHE (headaches) and CHILLS (chills). On 29-Mar-2021, DIZZINESS (Dizziness when laying down, and sitting up) had resolved. At the time of the report, PAIN (body aches), FEELING ABNORMAL (in the fog), HEADACHE (headaches) and CHILLS (chills) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. On an unknown date, Blood pressure tests and EKG's were performed. Blood work was done. Ears were inspected and lung and heart were listened to. Patient's blood pressure for 2 weeks and the ranges were normal most of the time with some elevated readings. Everything was normal, there were no findings. No treatment medications were reported. Most recent FOLLOW-UP information incorporated above includes: On 13-Jul-2021: Patient characteristics have updated. Concomitant drugs includes vitamin D, calcium, mag, zinc have been updated. Outcome of the event dizziness has updated

Other Meds: CALCIUM; MAGNESIUM; ZINC; VITAMIN D [COLECALCIFEROL]

Current Illness:

ID: 1560362
Sex: M
Age: 60
State: PA

Vax Date: 02/16/2021
Onset Date: 02/17/2021
Rec V Date: 08/15/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Skin dry after 1st dose; Skin itchy after 1st dose; Did not get the 2nd dose; shoulders and arms have some red zones on them; full body rash; full body rash, like a sunburn; it's not peeling but it's like flaking off/ skin flaked like dandruff; their skin like stings; their torso was completely red; This spontaneous case was reported by a consumer (subsequently medically confirmed) and describes the occurrence of RASH ERYTHEMATOUS (full body rash, like a sunburn), SKIN EXFOLIATION (it's not peeling but it's like flaking off/ skin flaked like dandruff), PAIN OF SKIN (their skin like stings), ERYTHEMA (their torso was completely red) and ERYTHEMA (shoulders and arms have some red zones on them) in a 60-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 006M20A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. Concurrent medical conditions included Cancer and Myeloma. Concomitant products included BORTEZOMIB (VELCADE) for Cancer, PROCHLORPERAZINE for Nausea, GABAPENTIN, LANSOPRAZOLE, ACETYLSALICYLIC ACID (BABY ASPIRIN), CALCIUM, ATORVASTATIN, DEXAMETHASONE and ACICLOVIR for an unknown indication. On 16-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 17-Feb-2021, the patient experienced RASH ERYTHEMATOUS (full body rash, like a sunburn), SKIN EXFOLIATION (it's not peeling but it's like flaking off/ skin flaked like dandruff), PAIN OF SKIN (their skin like stings), ERYTHEMA (their torso was completely red) and RASH (full body rash). On 22-Feb-2021, the patient experienced ERYTHEMA (shoulders and arms have some red zones on them). On an unknown date, the patient experienced DRY SKIN (Skin dry after 1st dose), PRURITUS (Skin itchy after 1st dose) and PRODUCT DOSE OMISSION ISSUE (Did not get the 2nd dose). In April 2021, SKIN EXFOLIATION (it's not peeling but it's like flaking off/ skin flaked like dandruff) had resolved. At the time of the report, RASH ERYTHEMATOUS (full body rash, like a sunburn), PAIN OF SKIN (their skin like stings), ERYTHEMA (their torso was completely red), ERYTHEMA (shoulders and arms have some red zones on them) and RASH (full body rash) outcome was unknown, DRY SKIN (Skin dry after 1st dose) and PRURITUS (Skin itchy after 1st dose) had not resolved and PRODUCT DOSE OMISSION ISSUE (Did not get the 2nd dose) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. The patient developed full body rash, like a sunburn, which started on their back and went to their chest and stomach. The rash was not peeling but was like flaking off, and later the rash was on their legs, arms, head and shoulder. Patient's skin was like stings and reported that he just had chemotherapy the same day and injection BORTEZOMIB for cancer. Patient's torso that got the rash first was completely red, and was not peeling anymore at the time of reporting, but their shoulders and arms were peeling, with some red zones on them. Patient's cancer doctor prescribed an unspecified steroid but reported that it did not do anything for the rash. Patient additionally reported in 14-APR-2021 that, his skin flaked like dandruff for about 7 weeks after the first dose. Patient's skin was still dry and itchy, at the time of report but was not shedding anymore. Patient reported to be using Vaseline like lotion to keep it moisturized. Patient also reported that he did not get the second dose as nobody would tell him if he should or not. Most recent FOLLOW-UP information incorporated above includes: On 01-Mar-2021: Follow up report included no new information On 14-Apr-2021: Follow up report included details of the events and outcome.

Other Meds: VELCADE; GABAPENTIN; LANSOPRAZOLE; BABY ASPIRIN; CALCIUM; ATORVASTATIN; PROCHLORPERAZINE; DEXAMETHASONE; ACICLOVIR

Current Illness: Cancer; Myeloma

ID: 1560363
Sex: F
Age: 73
State: TN

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

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 039K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: blurring in my right eye; woke with a bad throb in the right side of my head; heart was racing/fast heartbeat; left eye began twitching with sharp pains; left eye began twitching with sharp pains; tingling in lips; left eye felt very dry; left side of my neck felt sore/ got a tight feeling; left eye had begun to water; left side of my face had swollen; This spontaneous case was reported by a consumer and describes the occurrence of PARAESTHESIA ORAL (tingling in lips), ABNORMAL SENSATION IN EYE (left eye felt very dry), NECK PAIN (left side of my neck felt sore/ got a tight feeling), LACRIMATION INCREASED (left eye had begun to water) and SWELLING FACE (left side of my face had swollen) in a 74-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 010A21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 01-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 01-Mar-2021, the patient experienced PARAESTHESIA ORAL (tingling in lips), ABNORMAL SENSATION IN EYE (left eye felt very dry), NECK PAIN (left side of my neck felt sore/ got a tight feeling), LACRIMATION INCREASED (left eye had begun to water) and SWELLING FACE (left side of my face had swollen). On 05-Mar-2021, the patient experienced BLEPHAROSPASM (left eye began twitching with sharp pains) and EYE PAIN (left eye began twitching with sharp pains). On 30-Mar-2021, the patient experienced PALPITATIONS (heart was racing/fast heartbeat) and HEADACHE (woke with a bad throb in the right side of my head). On an unknown date, the patient experienced VISION BLURRED (blurring in my right eye). On 30-Mar-2021, HEADACHE (woke with a bad throb in the right side of my head) had resolved. In April 2021, SWELLING FACE (left side of my face had swollen) had resolved. At the time of the report, PARAESTHESIA ORAL (tingling in lips), ABNORMAL SENSATION IN EYE (left eye felt very dry), NECK PAIN (left side of my neck felt sore/ got a tight feeling), LACRIMATION INCREASED (left eye had begun to water) and VISION BLURRED (blurring in my right eye) outcome was unknown and PALPITATIONS (heart was racing/fast heartbeat), BLEPHAROSPASM (left eye began twitching with sharp pains) and EYE PAIN (left eye began twitching with sharp pains) had not resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medications reported. After 15 mins of vaccination, patient's lips began to tingle, left eye felt very dry and left side of my neck felt sore. After about 30 mins, patient's left eye had begun to water and the left side of my face had swollen. After four days of vaccination, patient's left eye began twitching with sharp pains, which patient experience often at the time of report. Patient also had blurring in right eye. On 30-MAR-2021, patient woke with a bad throb in the right side of head and heart was racing. After a few mins it cleared up, but patient had the fast heartbeat often, at the time of report. Treatment medications was not provided by the reporter Most recent FOLLOW-UP information incorporated above includes: On 03-May-2021: Follow up report included additional event details

Other Meds:

Current Illness:

ID: 1560364
Sex: F
Age:
State: NV

Vax Date: 01/21/2021
Onset Date: 02/25/2021
Rec V Date: 08/15/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Flu like symptoms; very hot to touch; Vaccination site itchy; Headache; Injection site was very red; Injection site rash; This spontaneous case was reported by a patient and describes the occurrence of INFLUENZA LIKE ILLNESS (Flu like symptoms), VACCINATION SITE WARMTH (very hot to touch), VACCINATION SITE PRURITUS (Vaccination site itchy), HEADACHE (Headache) and VACCINATION SITE ERYTHEMA (Injection site was very red) in a 71-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 012M20A and 012M20A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No medical history was provided by the reporter. Concomitant products included INSULIN GLARGINE (LANTUS), METOPROLOL TARTRATE, AMLODIPINE, OMEPRAZOLE, PIOGLITAZONE, HYDROCHLOROTHIAZIDE, GLIPIZIDE and TRAZODONE for an unknown indication. On 21-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 24-Feb-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 25-Feb-2021, the patient experienced INFLUENZA LIKE ILLNESS (Flu like symptoms), VACCINATION SITE WARMTH (very hot to touch), VACCINATION SITE PRURITUS (Vaccination site itchy), HEADACHE (Headache), VACCINATION SITE ERYTHEMA (Injection site was very red) and VACCINATION SITE RASH (Injection site rash). At the time of the report, INFLUENZA LIKE ILLNESS (Flu like symptoms), VACCINATION SITE WARMTH (very hot to touch), VACCINATION SITE PRURITUS (Vaccination site itchy), HEADACHE (Headache), VACCINATION SITE ERYTHEMA (Injection site was very red) and VACCINATION SITE RASH (Injection site rash) had resolved. Patient reported that the side effects healed after couple of days. Treatment medications was not provided by the reporter This case was linked to MOD-2021-030690 (Patient Link).

Other Meds: LANTUS; METOPROLOL TARTRATE; AMLODIPINE; OMEPRAZOLE; PIOGLITAZONE; HYDROCHLOROTHIAZIDE; GLIPIZIDE; TRAZODONE

Current Illness:

ID: 1560365
Sex: M
Age: 73
State:

Vax Date: 02/25/2021
Onset Date:
Rec V Date: 08/15/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 026LZOA
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Vomiting

Symptoms: pain in groin; This spontaneous case was reported by a non-health professional and describes the occurrence of GROIN PAIN (pain in groin) in a 73-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 023M20A) for COVID-19 vaccination. No medical history was provided by the reporter. Concomitant products included PREDNISONE for an unknown indication. On 25-Feb-2021, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On an unknown date, the patient experienced GROIN PAIN (pain in groin). At the time of the report, GROIN PAIN (pain in groin) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. This spontaneous case was reported by a and describes the occurrence of GROIN PAIN (pain in groin) in a 73-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. On an unknown date, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) at an unspecified dose. On an unknown date, the patient experienced GROIN PAIN (pain in groin). At the time of the report, GROIN PAIN (pain in groin) outcome was unknown. Patient take Amoxicillin and Prednisone as a Concomitant medication. Reporter did not allow further contact

Other Meds: PREDNISONE

Current Illness:

ID: 1560366
Sex: M
Age:
State: MA

Vax Date: 02/07/2021
Onset Date: 02/18/2021
Rec V Date: 08/15/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Patient experienced headache 1 & 1/2 week after receiving 1st dose; This spontaneous case was reported by a patient family member or friend and describes the occurrence of HEADACHE (Patient experienced headache 1 & 1/2 week after receiving 1st dose) in a 67-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 004M20A) for COVID-19 vaccination. The patient's past medical history included Surgery (Unspecified other surgery). Concomitant products included IBUPROFEN (ADVIL 12 HOUR) for Surgery. On 07-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) .5 milliliter. On 18-Feb-2021, the patient experienced HEADACHE (Patient experienced headache 1 & 1/2 week after receiving 1st dose). At the time of the report, HEADACHE (Patient experienced headache 1 & 1/2 week after receiving 1st dose) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Patient did not take any treatment for the event

Other Meds: ADVIL 12 HOUR

Current Illness:

ID: 1560367
Sex: F
Age: 84
State: NY

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

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

Lab Data:

Allergies:

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

Symptoms: generalized itching; feeling of tightness of throat; shortness of breath; This spontaneous case was reported by a physician and describes the occurrence of PRURITUS (generalized itching), THROAT TIGHTNESS (feeling of tightness of throat) and DYSPNOEA (shortness of breath) in an 84-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. Concomitant products included FEXOFENADINE, ALPRAZOLAM, CARVEDILOL, VITAMIN B12 (CYANOCOBALAMIN AND ANALOGUES), Esterase, THIOPHENE and USTELL for an unknown indication. On 15-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 15-Feb-2021, the patient experienced PRURITUS (generalized itching), THROAT TIGHTNESS (feeling of tightness of throat) and DYSPNOEA (shortness of breath). On 15-Feb-2021, THROAT TIGHTNESS (feeling of tightness of throat) and DYSPNOEA (shortness of breath) had resolved. At the time of the report, PRURITUS (generalized itching) 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: FEXOFENADINE; ALPRAZOLAM; CARVEDILOL; VITAMIN B12 (CYANOCOBALAMIN AND ANALOGUES); Esterase; THIOPHENE; USTELL

Current Illness:

ID: 1560368
Sex: M
Age:
State:

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

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

Lab Data:

Allergies:

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Tired; Fatigued; This spontaneous case was reported by a patient and describes the occurrence of FATIGUE (Tired) and FATIGUE (Fatigued) in a male patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 02-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 02-Feb-2021, the patient experienced FATIGUE (Tired) and FATIGUE (Fatigued). At the time of the report, FATIGUE (Tired) and FATIGUE (Fatigued) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant medications reported. Treatment medications was not provided by the reporter

Other Meds:

Current Illness:

ID: 1560369
Sex: F
Age: 72
State: FL

Vax Date: 01/30/2021
Onset Date: 03/01/2021
Rec V Date: 08/15/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: 2.5-3 inch hard spot on her arm (half the size of a tennis ball); Swelling and redness in the injection site; Swelling and redness in the injection site; More painful/soreness at the injection site post first dose; This spontaneous case was reported by a consumer and describes the occurrence of INJECTION SITE REACTION (2.5-3 inch hard spot on her arm (half the size of a tennis ball)), INJECTION SITE SWELLING (Swelling and redness in the injection site), INJECTION SITE ERYTHEMA (Swelling and redness in the injection site) and INJECTION SITE PAIN (More painful/soreness at the injection site post first dose) in a 72-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 031M20A and 030L20A) for COVID-19 vaccination. No Medical History information was reported. On 30-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 27-Feb-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 01-Mar-2021, the patient experienced INJECTION SITE REACTION (2.5-3 inch hard spot on her arm (half the size of a tennis ball)). 01-Mar-2021, the patient experienced INJECTION SITE SWELLING (Swelling and redness in the injection site), INJECTION SITE ERYTHEMA (Swelling and redness in the injection site) and INJECTION SITE PAIN (More painful/soreness at the injection site post first dose). The patient was treated with LORATADINE, PSEUDOEPHEDRINE HYDROCHLORIDE (BENADRYL 24 D) on 28-Feb-2021 for Injection site reaction, at a dose of 1 dosage form. At the time of the report, INJECTION SITE REACTION (2.5-3 inch hard spot on her arm (half the size of a tennis ball)), INJECTION SITE SWELLING (Swelling and redness in the injection site), INJECTION SITE ERYTHEMA (Swelling and redness in the injection site) and INJECTION SITE PAIN (More painful/soreness at the injection site post first dose) had not resolved. As treatment patient also applied ice but with no relief This case was linked to MOD-2021-030659 (Patient Link).

Other Meds:

Current Illness:

ID: 1560370
Sex: F
Age: 67
State: FL

Vax Date: 02/25/2021
Onset Date: 02/25/2021
Rec V Date: 08/15/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: arm was sore at the injection site; hot at the injection site; red at injection site; face got red & blotchy; neck got red & blotchy; mouth got very dry; throat tightened up; This spontaneous case was reported by a consumer and describes the occurrence of ERYTHEMA (face got red & blotchy), ERYTHEMA (neck got red & blotchy), PAIN IN EXTREMITY (arm was sore at the injection site), DRY MOUTH (mouth got very dry) and VACCINATION SITE WARMTH (hot at the injection site) in a 67-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 001A21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 25-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 25-Feb-2021, the patient experienced DRY MOUTH (mouth got very dry) and THROAT TIGHTNESS (throat tightened up). On 25-Feb-2021 at 12:05 AM, the patient experienced ERYTHEMA (face got red & blotchy) and ERYTHEMA (neck got red & blotchy). On 26-Feb-2021, the patient experienced PAIN IN EXTREMITY (arm was sore at the injection site), VACCINATION SITE WARMTH (hot at the injection site) and VACCINATION SITE ERYTHEMA (red at injection site). At the time of the report, ERYTHEMA (face got red & blotchy), ERYTHEMA (neck got red & blotchy), PAIN IN EXTREMITY (arm was sore at the injection site), DRY MOUTH (mouth got very dry), VACCINATION SITE WARMTH (hot at the injection site), THROAT TIGHTNESS (throat tightened up) and VACCINATION SITE ERYTHEMA (red at injection site) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medications reported. Treatment medications was not provided by the reporter

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am