VAERS 2021 Database www.vaers.hhs.gov

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

Total Manufacturer

Incidents per State

State Total
92,076
AK1,880
AL6,345
AR4,151
AS46
AZ14,991
CA66,887
CO12,550
CT8,943
DC1,795
DE2,009
FL42,724
FM4
GA17,031
GU124
HI2,580
IA4,919
ID2,892
IL22,128
IN24,197
KS5,047
KY9,111
LA5,500
MA15,718
MD13,434
ME3,351
MH8
MI20,971
MN13,585
MO10,747
MP30
MS3,198
MT2,477
NC18,051
ND1,501
NE3,109
NH3,218
NJ20,216
NM4,218
NV4,728
NY37,667
OH20,793
OK6,692
OR9,244
PA25,607
PR2,588
QM2
RI2,163
SC7,261
SD1,282
TN10,445
TX39,890
UT4,618
VA15,980
VI67
VT1,830
WA16,071
WI12,042
WV2,571
WY926
XB5
XL1
XV2

ID: 1566210
Sex: M
Age:
State: CA

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

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

Lab Data:

Allergies:

Symptom List: Dysphagia, Epiglottitis

Symptoms: Knock him out for a day; This spontaneous case was reported by a consumer and describes the occurrence of FATIGUE (Knock him out for a day) in a male patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The patient's past medical history included COVID-19 in August 2020. On 19-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 FATIGUE (Knock him out for a day). On 19-Feb-2021, FATIGUE (Knock him out for a day) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medications were provided by the reporter. Treatment information was not provided.

Other Meds:

Current Illness:

ID: 1566211
Sex: F
Age: 69
State: MI

Vax Date: 03/10/2021
Onset Date: 03/10/2021
Rec V Date: 08/15/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Anxiety, Dyspnoea

Symptoms: Congested tight feeling in upper throat after 1st dose; This spontaneous case was reported by a consumer and describes the occurrence of THROAT TIGHTNESS (Congested tight feeling in upper throat after 1st dose) in a 69-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 044a21a) for COVID-19 vaccination. Concomitant products included AMLODIPINE, LISINOPRIL, CARVEDILOL, PANTOPRAZOLE, ATORVASTATIN and MONTELUKAST for an unknown indication. On 10-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 10-Mar-2021, the patient experienced THROAT TIGHTNESS (Congested tight feeling in upper throat after 1st dose). At the time of the report, THROAT TIGHTNESS (Congested tight feeling in upper throat after 1st dose) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No treatment Information was reported.

Other Meds: AMLODIPINE; LISINOPRIL; CARVEDILOL; PANTOPRAZOLE; ATORVASTATIN; MONTELUKAST

Current Illness:

ID: 1566212
Sex: M
Age: 73
State: PA

Vax Date: 02/27/2021
Onset Date: 02/01/2021
Rec V Date: 08/15/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Pain on right arm; Tested covid-19 positive after 1st dose; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (Pain on right arm) and SARS-COV-2 TEST POSITIVE (Tested covid-19 positive after 1st dose) in a 73-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 025821A) for COVID-19 vaccination. The patient's past medical history included Kidney stones, Heart racing and Cancer. Concomitant products included METOPROLOL and WARFARIN for an unknown indication. On 27-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. In February 2021, after starting mRNA-1273 (Moderna COVID-19 Vaccine), the patient experienced SARS-COV-2 TEST POSITIVE (Tested covid-19 positive after 1st dose). On 27-Feb-2021, the patient experienced PAIN IN EXTREMITY (Pain on right arm). At the time of the report, PAIN IN EXTREMITY (Pain on right arm) and SARS-COV-2 TEST POSITIVE (Tested covid-19 positive after 1st dose) outcome was unknown. Not Provided DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): In February 2021, SARS-CoV-2 test: positive (Positive) Positive. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No treatment information was provided.

Other Meds: METOPROLOL; WARFARIN

Current Illness:

ID: 1566213
Sex: F
Age: 37
State: NC

Vax Date: 02/13/2021
Onset Date:
Rec V Date: 08/15/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Stiff neck pain, could not move; headache; describes the occurrence of NECK PAIN (Stiff neck pain, could not move) and HEADACHE (headache) in a 57-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 031/20A) for COVID-19 vaccination. No Medical History information was reported. On 13-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On an unknown date, the patient experienced NECK PAIN (Stiff neck pain, could not move) and HEADACHE (headache). The patient was treated with IBUPROFEN at an unspecified dose and frequency. At the time of the report, NECK PAIN (Stiff neck pain, could not move) and HEADACHE (headache) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medications were reported.

Other Meds:

Current Illness:

ID: 1566214
Sex: M
Age: 70
State: NJ

Vax Date: 03/10/2021
Onset Date: 03/10/2021
Rec V Date: 08/15/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Fever; Headache; Muscle aches all over his body; This spontaneous case was reported by a consumer and describes the occurrence of PYREXIA (Fever), HEADACHE (Headache) and MYALGIA (Muscle aches all over his body) in a 70-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No medical history was provided by the reporter. Concomitant products included PRAVASTATIN for Cholesterol, LOSARTAN for Hypertension. On 10-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 10-Mar-2021 at 6:30 PM, the patient experienced PYREXIA (Fever), HEADACHE (Headache) and MYALGIA (Muscle aches all over his body). The patient was treated with IBUPROFEN (ADVIL [IBUPROFEN]) at a dose of 1 dosage form. On 11-Mar-2021, PYREXIA (Fever), HEADACHE (Headache) and MYALGIA (Muscle aches all over his body) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown.

Other Meds: PRAVASTATIN; LOSARTAN

Current Illness:

ID: 1566215
Sex: F
Age: 74
State: WI

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

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

Lab Data:

Allergies:

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

Symptoms: dizziness; felt like she had to vomit; Low grade fever 101.9; This spontaneous case was reported by a consumer and describes the occurrence of DIZZINESS (dizziness), NAUSEA (felt like she had to vomit) and PYREXIA (Low grade fever 101.9) in a 74-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. Concurrent medical conditions included Osteoporosis. Concomitant products included CALCIUM PHOSPHATE DIBASIC, ERGOCALCIFEROL (VITAMIN D2 AND CALCIUM HYDROGEN PHOSPHATE) for Osteoporosis, RIVAROXABAN (XARELTO) and ATENOLOL for an unknown indication. On 17-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 DIZZINESS (dizziness), NAUSEA (felt like she had to vomit) and PYREXIA (Low grade fever 101.9). At the time of the report, DIZZINESS (dizziness), NAUSEA (felt like she had to vomit) and PYREXIA (Low grade fever 101.9) had not resolved. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 17-Feb-2021, Body temperature: 101.9 (Inconclusive) Low grade fever 101.9. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. Treatment information was not provided This case was linked to MOD-2021-257168 (Patient Link). Most recent FOLLOW-UP information incorporated above includes: On 05-May-2021: Non significant follow up received on 06-MAY-2021. Patient say's she could not figure out how to send the filled out ADR form. On 14-Jul-2021: No new information received

Other Meds: XARELTO; ATENOLOL; VITAMIN D2 AND CALCIUM HYDROGEN PHOSPHATE

Current Illness:

ID: 1566216
Sex: F
Age: 51
State: PA

Vax Date: 01/07/2021
Onset Date: 02/05/2021
Rec V Date: 08/15/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: This spontaneous case was reported by an other health care professional and describes the occurrence of PAIN IN EXTREMITY (sore arm), ERYTHEMA (arm is inflame, developed redness and an increment on local temperature), RASH (arm developed a rash between the shoulder and the elbow, kind of cellulitis), CHILLS (chills) and FATIGUE (tired) in a 52-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 012M20A and 012M20A) for COVID-19 vaccination. No Medical History information was reported. On 07-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 05-Feb-2021 at 7:00 AM, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 05-Feb-2021, the patient experienced PAIN IN EXTREMITY (sore arm). 05-Feb-2021, the patient experienced CHILLS (chills) and FATIGUE (tired). On 06-Feb-2021, the patient experienced ERYTHEMA (arm is inflame, developed redness and an increment on local temperature) and RASH (arm developed a rash between the shoulder and the elbow, kind of cellulitis). At the time of the report, PAIN IN EXTREMITY (sore arm), ERYTHEMA (arm is inflame, developed redness and an increment on local temperature), RASH (arm developed a rash between the shoulder and the elbow, kind of cellulitis), CHILLS (chills) and FATIGUE (tired) outcome was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. No relevant concomitant medications were reported. For treatment patient reported applying cold compresses as palliative care. This case was linked to MOD-2021-024720 (Patient Link).

Other Meds:

Current Illness:

ID: 1566217
Sex: F
Age: 90
State: IL

Vax Date: 02/12/2021
Onset Date: 03/10/2021
Rec V Date: 08/15/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Pharyngeal swelling

Symptoms: Lower back pain; This spontaneous case was reported by a consumer and describes the occurrence of BACK PAIN (Lower back pain) in a 90-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 039K20-2A) for COVID-19 vaccination. No Medical History information was reported. On 12-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 10-Mar-2021, the patient experienced BACK PAIN (Lower back pain). At the time of the report, BACK PAIN (Lower back pain) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Concomitant product use was not provided by the reporter. The patient attributed the lower back pain might be due to poor sleeping position. On 12-Mar-2021, the patient received the second dose. No treatment information was provided.

Other Meds:

Current Illness:

ID: 1566218
Sex: F
Age:
State: VT

Vax Date: 03/12/2021
Onset Date: 03/12/2021
Rec V Date: 08/15/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Breathing is off; This spontaneous case was reported by a consumer and describes the occurrence of DYSPNOEA (Breathing is off) in a 66-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. Concurrent medical conditions included Pulmonary disorder. On 12-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 12-Mar-2021, the patient experienced DYSPNOEA (Breathing is off). At the time of the report, DYSPNOEA (Breathing is off) outcome was unknown. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Concomitant product use was not provided by the reporter. No treatment information was provided. The patient stated in the follow up that she did not have a reaction first time. Most recent FOLLOW-UP information incorporated above includes: On 07-Apr-2021: Follow up was received and no ne w information was provided.

Other Meds:

Current Illness: Pulmonary disorder

ID: 1566219
Sex: F
Age: 76
State: NJ

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

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

Lab Data:

Allergies:

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Local tenderness at the injection site; This spontaneous case was reported by a physician and describes the occurrence of VACCINATION SITE PAIN (Local tenderness at the injection site) in a 76-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 011L20A) for COVID-19 vaccination. Concomitant products included AMLODIPINE, LEVOTHYROXINE and METFORMIN 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 an unknown date, the patient experienced VACCINATION SITE PAIN (Local tenderness at the injection site). At the time of the report, VACCINATION SITE PAIN (Local tenderness at the injection site) outcome was unknown. 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. Patient has an unspecified underlying condition. Treatment information was not provided.

Other Meds: AMLODIPINE; LEVOTHYROXINE; METFORMIN

Current Illness:

ID: 1566220
Sex: F
Age: 68
State: CA

Vax Date: 03/11/2021
Onset Date: 03/11/2021
Rec V Date: 08/15/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: soreness; Nausea; fever; rash on arms, and back; Vomiting; This spontaneous case was reported by a consumer and describes the occurrence of ARTHRALGIA (soreness), NAUSEA (Nausea), PYREXIA (fever), RASH (rash on arms, and back) and VOMITING (Vomiting) in a 68-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 002B21A) for COVID-19 vaccination. The patient's past medical history included No adverse event. On 11-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 11-Mar-2021, the patient experienced ARTHRALGIA (soreness), NAUSEA (Nausea), PYREXIA (fever), RASH (rash on arms, and back) and VOMITING (Vomiting). At the time of the report, ARTHRALGIA (soreness), NAUSEA (Nausea), PYREXIA (fever), RASH (rash on arms, and back) and VOMITING (Vomiting) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant medication was reported. Treatment was reported as Tylenol, wet towels and diclofenac.

Other Meds:

Current Illness:

ID: 1566221
Sex: F
Age: 54
State:

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

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

Lab Data:

Allergies:

Symptom List: Rash, Urticaria

Symptoms: Numbness and tingling of the face, neck and shoulder; Numbness and tingling of the face, neck and shoulder; This spontaneous case was reported by a consumer and describes the occurrence of HYPOAESTHESIA (Numbness and tingling of the face, neck and shoulder) and PARAESTHESIA (Numbness and tingling of the face, neck and shoulder) in a 56-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 002H21A) for COVID-19 vaccination. No medical history was reported. On 23-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On an unknown date, the patient experienced HYPOAESTHESIA (Numbness and tingling of the face, neck and shoulder) and PARAESTHESIA (Numbness and tingling of the face, neck and shoulder). At the time of the report, HYPOAESTHESIA (Numbness and tingling of the face, neck and shoulder) and PARAESTHESIA (Numbness and tingling of the face, neck and shoulder) outcome was unknown. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No Concomitant information was provided. No Treatment information was provided.

Other Meds:

Current Illness:

ID: 1566222
Sex: F
Age: 100
State: MI

Vax Date: 02/08/2021
Onset Date: 03/09/2021
Rec V Date: 08/15/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Swollen lip; Rash (on her arm, cross her chest, and legs); This spontaneous case was reported by a consumer and describes the occurrence of LIP SWELLING (Swollen lip) and RASH (Rash (on her arm, cross her chest, and legs)) in a 100-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 030A21A and 013M20A) for COVID-19 vaccination. No Medical History information was reported. On 08-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 08-Mar-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 09-Mar-2021, the patient experienced LIP SWELLING (Swollen lip) and RASH (Rash (on her arm, cross her chest, and legs)). The patient was treated with DIPHENHYDRAMINE HYDROCHLORIDE (BENADRYL [DIPHENHYDRAMINE HYDROCHLORIDE]) for Rash, at an unspecified dose and frequency. On 10-Mar-2021, LIP SWELLING (Swollen lip) had resolved. At the time of the report, RASH (Rash (on her arm, cross her chest, and legs)) had not resolved. No concomitant medications was reported. Action taken with mRNA-1273 in response to the events was not applicable.

Other Meds:

Current Illness:

ID: 1566223
Sex: F
Age: 72
State: FL

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

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

Lab Data:

Allergies:

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

Symptoms: Sore arm; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (Sore arm) in a 72-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 011L20A and 031L20A) for COVID-19 vaccination. The patient's past medical history included No adverse event (No reported medical history). On 08-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 05-Feb-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On an unknown date, the patient experienced PAIN IN EXTREMITY (Sore arm). At the time of the report, PAIN IN EXTREMITY (Sore arm) outcome was unknown. Onset Date: ??-???-2021 The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No relevant concomitant medications were reported. Treatment details were not provided. Based on the current available information and temporal association between the use of the product and the start date of the event, a causal relationship cannot be excluded. This case was linked to MOD-2021-029064 (Patient Link).; Sender's Comments: Based on the current available information and temporal association between the use of the product and the start date of the event, a causal relationship cannot be excluded.

Other Meds:

Current Illness:

ID: 1566224
Sex: F
Age:
State:

Vax Date: 03/12/2021
Onset Date:
Rec V Date: 08/15/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: 3x black stool; This spontaneous case was reported by an other and describes the occurrence of FAECES DISCOLOURED (3x black stool) in a 69-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 12-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced FAECES DISCOLOURED (3x black stool). At the time of the report, FAECES DISCOLOURED (3x black stool) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Concomitant product use was not provided. Treatment information was not provided

Other Meds:

Current Illness:

ID: 1566225
Sex: U
Age:
State:

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

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

Lab Data:

Allergies:

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

Symptoms: Felt lightheaded; couldn't sleep for exactly 12 hours; headachy; very tired; This spontaneous case was reported by a patient and describes the occurrence of DIZZINESS (Felt lightheaded), INSOMNIA (couldn't sleep for exactly 12 hours), HEADACHE (headachy) and FATIGUE (very tired) 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 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 DIZZINESS (Felt lightheaded), INSOMNIA (couldn't sleep for exactly 12 hours), HEADACHE (headachy) and FATIGUE (very tired). At the time of the report, DIZZINESS (Felt lightheaded), INSOMNIA (couldn't sleep for exactly 12 hours), HEADACHE (headachy) and FATIGUE (very tired) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Concomitant medications and treatment information were not provided.

Other Meds:

Current Illness:

ID: 1566226
Sex: F
Age:
State: CA

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

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

Lab Data:

Allergies:

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

Symptoms: paraesthesia; Body wide intense itchiness; tickle in throat; Hives in flushes over arms,trunk,face and upper legs; some sensation of tightening; increased mucous production; several weeks late on 2nd dose; closed up 2nd dose appointments for all the health care providers without notice; dry itchy eyes; dry itchy eyes; This spontaneous case was reported by a nurse and describes the occurrence of PARAESTHESIA (paraesthesia), PRURITUS (Body wide intense itchiness), OROPHARYNGEAL DISCOMFORT (tickle in throat), URTICARIA (Hives in flushes over arms,trunk,face and upper legs) and THROAT TIGHTNESS (some sensation of tightening) in a female patient of an unknown age 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. Co-suspect product included non-company product CETIRIZINE for an unknown indication. Concurrent medical conditions included Paraesthesia generalised (Without known cause which flares during some viral infections or intense heat/ UV exposure. It is usually at a low fuzzy feeling but intensifies to pin-pricks when viral sickness.) since 2010. On 16-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On an unknown date, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form and CETIRIZINE (unknown route) at an unspecified dose. On an unknown date, the patient experienced PARAESTHESIA (paraesthesia), PRURITUS (Body wide intense itchiness), OROPHARYNGEAL DISCOMFORT (tickle in throat), URTICARIA (Hives in flushes over arms,trunk,face and upper legs), THROAT TIGHTNESS (some sensation of tightening), SECRETION DISCHARGE (increased mucous production), EYE PRURITUS (dry itchy eyes), DRY EYE (dry itchy eyes), PRODUCT ADMINISTRATION INTERRUPTED (several weeks late on 2nd dose) and PRODUCT AVAILABILITY ISSUE (closed up 2nd dose appointments for all the health care providers without notice). At the time of the report, PARAESTHESIA (paraesthesia), PRURITUS (Body wide intense itchiness), OROPHARYNGEAL DISCOMFORT (tickle in throat), URTICARIA (Hives in flushes over arms,trunk,face and upper legs), THROAT TIGHTNESS (some sensation of tightening) and SECRETION DISCHARGE (increased mucous production) outcome was unknown and EYE PRURITUS (dry itchy eyes), DRY EYE (dry itchy eyes), PRODUCT ADMINISTRATION INTERRUPTED (several weeks late on 2nd dose) and PRODUCT AVAILABILITY ISSUE (closed up 2nd dose appointments for all the health care providers without notice) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No concomitant product use was reported No treatment information was provided Action taken with mRNA-1273 in response to the event was not applicable. Patient took cetirizine prior to vaccination with standby epinephrine. A second dose of cetirizine was taken at onset. This case was linked to MOD-2021-004774 (Patient Link).

Other Meds: CETIRIZINE

Current Illness: Paraesthesia generalised (Without known cause which flares during some viral infections or intense heat/ UV exposure. It is usually at a low fuzzy feeling but intensifies to pin-pricks when viral sickness.)

ID: 1566227
Sex: M
Age:
State: NC

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

Vax Type:
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Lab Data:

Allergies:

Symptom List: Ear pain, Hypoaesthesia

Symptoms: COVID arm; Felt like it was a little hard/harder than the other the arm; COVID arm/ quarter size of a cell phone; Light red in color; Pain all along/pain to the touch; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE REACTION (COVID arm), VACCINATION SITE INDURATION (Felt like it was a little hard/harder than the other the arm), VACCINATION SITE PAIN (Pain all along/pain to the touch), VACCINATION SITE RASH (COVID arm/ quarter size of a cell phone) and VACCINATION SITE ERYTHEMA (Light red in color) in a 64-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 025A21A) for COVID-19 vaccination. Concurrent medical conditions included Type 2 diabetes mellitus (on medication). 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 (Pain all along/pain to the touch). On 11-Mar-2021, the patient experienced VACCINATION SITE REACTION (COVID arm), VACCINATION SITE INDURATION (Felt like it was a little hard/harder than the other the arm), VACCINATION SITE RASH (COVID arm/ quarter size of a cell phone) and VACCINATION SITE ERYTHEMA (Light red in color). At the time of the report, VACCINATION SITE REACTION (COVID arm), VACCINATION SITE INDURATION (Felt like it was a little hard/harder than the other the arm), VACCINATION SITE PAIN (Pain all along/pain to the touch), VACCINATION SITE RASH (COVID arm/ quarter size of a cell phone) and VACCINATION SITE ERYTHEMA (Light red in color) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Concomitant medications include medication for diabetes. Treatment information was not provided

Other Meds:

Current Illness: Type 2 diabetes mellitus (on medication)

ID: 1566228
Sex: M
Age: 61
State: FL

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

Vax Type:
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Lab Data:

Allergies:

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: past the 42 day window; This spontaneous case was reported by a consumer and describes the occurrence of PRODUCT DOSE OMISSION ISSUE (past the 42 day window) in a 61-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 011620A) for COVID-19 vaccination. No Medical History information was reported. On 09-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On an unknown date, the patient experienced PRODUCT DOSE OMISSION ISSUE (past the 42 day window). At the time of the report, PRODUCT DOSE OMISSION ISSUE (past the 42 day window) outcome was unknown. Unknown The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No relevant concomitant medications were reported. No treatment information was reported.

Other Meds:

Current Illness:

ID: 1566229
Sex: F
Age: 75
State: CO

Vax Date: 01/07/2021
Onset Date: 02/04/2021
Rec V Date: 08/15/2021
Hospital:

Vax Type:
Manufacturer:
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Lab Data:

Allergies:

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

Symptoms: Drop in oxygen level; Drop in blood pressure; Really tired, layed down and went to sleep; This spontaneous case was reported by a consumer and describes the occurrence of OXYGEN CONSUMPTION DECREASED (Drop in oxygen level), BLOOD PRESSURE DECREASED (Drop in blood pressure) and FATIGUE (Really tired, layed down and went to sleep) in a 75-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 027LZ0A (possibly H) and 010M20A) for COVID-19 vaccination. The patient's past medical history included No adverse event (No reported medical history). On 07-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 04-Feb-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 04-Feb-2021, the patient experienced FATIGUE (Really tired, layed down and went to sleep). On 05-Feb-2021, the patient experienced OXYGEN CONSUMPTION DECREASED (Drop in oxygen level) and BLOOD PRESSURE DECREASED (Drop in blood pressure). At the time of the report, OXYGEN CONSUMPTION DECREASED (Drop in oxygen level), BLOOD PRESSURE DECREASED (Drop in blood pressure) and FATIGUE (Really tired, layed down and went to sleep) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 05-Feb-2021, Blood pressure measurement: 81/51 mmHg Low. On 05-Feb-2021, Oxygen saturation: 78 % Low. On 09-Feb-2021, Blood pressure measurement: mmHg Low. On 09-Feb-2021, Oxygen saturation: 87 % Low. Treatment information included oxygen and discontinuation of blood pressure medicine. Action taken with mRNA-1273 in response to the events was not applicable. This case was linked to MOD-2021-027684 (Patient Link).

Other Meds:

Current Illness:

ID: 1566230
Sex: F
Age: 52
State: TX

Vax Date: 03/11/2021
Onset Date:
Rec V Date: 08/15/2021
Hospital:

Vax Type:
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Lab Data:

Allergies:

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

Symptoms: Difficulty breathing; High blood pressure; Headache; This spontaneous case was reported by a consumer and describes the occurrence of DYSPNOEA (Difficulty breathing), HYPERTENSION (High blood pressure) and HEADACHE (Headache) in a 53-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No medical history was provided by the reporter. Concomitant products included ATORVASTATIN for an unknown indication. On 11-Mar-2021, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced DYSPNOEA (Difficulty breathing), HYPERTENSION (High blood pressure) and HEADACHE (Headache). At the time of the report, DYSPNOEA (Difficulty breathing), HYPERTENSION (High blood pressure) and HEADACHE (Headache) outcome was unknown. Not Provided DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): In March 2021, Blood pressure measurement: increased (High) Increased. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Treatment information was not provided. Reporter did not allow further contact Most recent FOLLOW-UP information incorporated above includes: On 05-May-2021: Follow-up included: Denied consent for follow up.

Other Meds: ATORVASTATIN

Current Illness:

ID: 1566231
Sex: M
Age:
State: FL

Vax Date: 03/10/2021
Onset Date: 03/10/2021
Rec V Date: 08/15/2021
Hospital:

Vax Type:
Manufacturer:
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Lab Data:

Allergies:

Symptom List: Unevaluable event

Symptoms: High blood pressure; Fast heart rate; Chills; Fever 101.9; Joint pain; Fatigue; Sore arm; This spontaneous case was reported by a consumer and describes the occurrence of HYPERTENSION (High blood pressure), PALPITATIONS (Fast heart rate), CHILLS (Chills), PYREXIA (Fever 101.9) and ARTHRALGIA (Joint pain) in a 67-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 040A21A) 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 BIOTIN, CURCUMA LONGA (TURMERIC [CURCUMA LONGA]), GLUCOSAMINE and OMEPRAZOLE for an unknown indication. On 10-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 10-Mar-2021, the patient experienced VACCINATION SITE PAIN (Sore arm). On 11-Mar-2021, the patient experienced HYPERTENSION (High blood pressure), PALPITATIONS (Fast heart rate), CHILLS (Chills), PYREXIA (Fever 101.9), ARTHRALGIA (Joint pain) and FATIGUE (Fatigue). At the time of the report, HYPERTENSION (High blood pressure), PALPITATIONS (Fast heart rate), CHILLS (Chills), PYREXIA (Fever 101.9), ARTHRALGIA (Joint pain), FATIGUE (Fatigue) and VACCINATION SITE PAIN (Sore arm) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Concomitant medication included centrum. No treatment information was provided. This case was linked to MOD-2021-109516 (Patient Link). Most recent FOLLOW-UP information incorporated above includes: On 05-May-2021: Updated reporter information and concomitant medication information.

Other Meds: BIOTIN; TURMERIC [CURCUMA LONGA]; GLUCOSAMINE; OMEPRAZOLE

Current Illness:

ID: 1566232
Sex: F
Age: 86
State: GA

Vax Date: 02/13/2021
Onset Date: 03/06/2021
Rec V Date: 08/15/2021
Hospital:

Vax Type:
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Lab Data:

Allergies:

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

Symptoms: Urinary tract infection; This spontaneous case was reported by a consumer and describes the occurrence of URINARY TRACT INFECTION (Urinary tract infection) in an 86-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 031L20A) for COVID-19 vaccination. No Medical History information was reported. On 13-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 06-Mar-2021, the patient experienced URINARY TRACT INFECTION (Urinary tract infection). At the time of the report, URINARY TRACT INFECTION (Urinary tract infection) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No Concomitant medications was reported Treatment information was not provided

Other Meds:

Current Illness:

ID: 1566233
Sex: M
Age: 26
State: UT

Vax Date: 03/10/2021
Onset Date: 03/11/2021
Rec V Date: 08/15/2021
Hospital:

Vax Type:
Manufacturer:
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Vax Site:

Lab Data:

Allergies:

Symptom List: Injection site pain, Pain

Symptoms: This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE URTICARIA (Hives) in a 26-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 001B21A) for COVID-19 vaccination. No Medical History information was reported. On 10-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 11-Mar-2021, the patient experienced VACCINATION SITE URTICARIA (Hives). The patient was treated with DIPHENHYDRAMINE HYDROCHLORIDE (BENADRYL [DIPHENHYDRAMINE HYDROCHLORIDE]) ongoing since an unknown date for Hives, at a dose of 1 dosage form and CETIRIZINE HYDROCHLORIDE (ZYRTEC [CETIRIZINE HYDROCHLORIDE]) ongoing since an unknown date for Hives, at a dose of 1 dosage form. At the time of the report, VACCINATION SITE URTICARIA (Hives) outcome was unknown. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medication was reported.

Other Meds:

Current Illness:

ID: 1566234
Sex: F
Age: 66
State: NC

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

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

Lab Data:

Allergies:

Symptom List: Injection site pain, Menorrhagia

Symptoms: This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (Sore arm) and VACCINATION SITE RASH (Rash at injection site) in a 66-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 036A21A) for COVID-19 vaccination. No Medical History information was reported. On 03-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 03-Mar-2021, the patient experienced PAIN IN EXTREMITY (Sore arm). On 11-Mar-2021, the patient experienced VACCINATION SITE RASH (Rash at injection site). On 04-Mar-2021, PAIN IN EXTREMITY (Sore arm) outcome was unknown. At the time of the report, VACCINATION SITE RASH (Rash at injection site) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Concomitant product use was not provided by the reporter. ? No treatment information was provided.

Other Meds:

Current Illness:

ID: 1566235
Sex: M
Age:
State: TX

Vax Date: 03/12/2021
Onset Date: 03/12/2021
Rec V Date: 08/15/2021
Hospital:

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

Allergies:

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

Symptoms: soreness of left arm; This spontaneous case was reported by a consumer (subsequently medically confirmed) and describes the occurrence of INJECTION SITE PAIN (soreness of left arm) in a 63-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 031A21A) for COVID-19 vaccination. No Medical History information was reported. On 12-Mar-2021, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 12-Mar-2021, the patient experienced INJECTION SITE PAIN (soreness of left arm). At the time of the report, INJECTION SITE PAIN (soreness of left arm) outcome was unknown. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments.

Other Meds:

Current Illness:

ID: 1566236
Sex: F
Age: 38
State: IN

Vax Date: 03/03/2021
Onset Date: 03/11/2021
Rec V Date: 08/15/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: swollen tongue; hives on the left side of her body including the back of her arm, hip, elbow and foot; muscle pain; This spontaneous case was reported by a nurse and describes the occurrence of SWOLLEN TONGUE (swollen tongue), URTICARIA (hives on the left side of her body including the back of her arm, hip, elbow and foot) and MYALGIA (muscle pain) in a 38-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 011J20A) for COVID-19 vaccination. No Medical History information was reported. On 03-Mar-2021 at 12:10 PM, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 11-Mar-2021, the patient experienced SWOLLEN TONGUE (swollen tongue), URTICARIA (hives on the left side of her body including the back of her arm, hip, elbow and foot) and MYALGIA (muscle pain). The patient was treated with DIPHENHYDRAMINE HYDROCHLORIDE (BENADRYL [DIPHENHYDRAMINE HYDROCHLORIDE]) at an unspecified dose and frequency. At the time of the report, SWOLLEN TONGUE (swollen tongue), URTICARIA (hives on the left side of her body including the back of her arm, hip, elbow and foot) and MYALGIA (muscle pain) 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 considered SWOLLEN TONGUE (swollen tongue), URTICARIA (hives on the left side of her body including the back of her arm, hip, elbow and foot) and MYALGIA (muscle pain) to be probably related. No concomitant medications were provided by the reporter. Most recent FOLLOW-UP information incorporated above includes: On 07-May-2021: Patient demographics, event start date added

Other Meds:

Current Illness:

ID: 1566237
Sex: M
Age:
State: FL

Vax Date: 02/06/2021
Onset Date:
Rec V Date: 08/15/2021
Hospital:

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

Allergies:

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Food poisoning; This spontaneous case was reported by a consumer and describes the occurrence of FOOD POISONING (Food poisoning) in a 72-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 031L20A) for COVID-19 vaccination. No Medical History information was reported. On 06-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On an unknown date, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On an unknown date, the patient experienced FOOD POISONING (Food poisoning). At the time of the report, FOOD POISONING (Food poisoning) outcome was unknown. No concomitant medications were provided by the reporter. Patient was able to get the second shot within the recommend time frame.Treatment information was not provided. Company comment: Based on current available information and the temporal association between product use and the start date of the event a causal relationship is unlikely. Most recent FOLLOW-UP information incorporated above includes: On 30-Mar-2021: Product dose omission event deleted. Hospitalization was added.; Reporter's Comments: Very limited information regarding this event has been provided at this time. Further information has been requested. However based on know profile of the vaccine and common source of food poisoning; it is unlikely related to vaccine.; Sender's Comments: Based on current available information and the temporal association between product use and the start date of the event a causal relationship is unlikely.

Other Meds:

Current Illness:

ID: 1566238
Sex: U
Age:
State: IL

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

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

Lab Data:

Allergies:

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

Symptoms: patients port has not been working properly /they have been using a solution they called draino to help flush out the port"/they have been using a solution they called draino to help flush out the port"; Patient has no other symptoms after receiving the vaccine; Based on the current case data, this case has been classified as invalid. This spontaneous case was reported by a pharmacist and describes the occurrence of CATHETER MANAGEMENT (patients port has not been working properly /they have been using a solution they called draino to help flush out the port"/they have been using a solution they called draino to help flush out the port") and NO ADVERSE EVENT (Patient has no other symptoms after receiving the vaccine) 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 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 CATHETER MANAGEMENT (patients port has not been working properly /they have been using a solution they called draino to help flush out the port"/they have been using a solution they called draino to help flush out the port") and NO ADVERSE EVENT (Patient has no other symptoms after receiving the vaccine). At the time of the report, CATHETER MANAGEMENT (patients port has not been working properly /they have been using a solution they called draino to help flush out the port"/they have been using a solution they called draino to help flush out the port") and NO ADVERSE EVENT (Patient has no other symptoms after receiving the vaccine) outcome was unknown. 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. No relevant concomitant medication was reported. Treatment information was not provided. Patient reported that they used a solution called draino to help flush out the port.

Other Meds:

Current Illness:

ID: 1566239
Sex: F
Age: 37
State: NJ

Vax Date: 03/12/2021
Onset Date: 03/12/2021
Rec V Date: 08/15/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Nausea

Symptoms: Pregnancy; This spontaneous prospective pregnancy case was reported by a consumer and describes the occurrence of EXPOSURE DURING PREGNANCY (Pregnancy) in a 37-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 044A21A) for COVID-19 vaccination. The patient's past medical history included Pregnancy (No complications, live full time birth) on 15-Feb-2016, Pregnancy (No complications, live full time birth) on 07-Apr-2018 and Alcohol use (social). Concomitant products included MINERALS NOS, VITAMINS NOS (PRENATAL VITAMINS [MINERALS NOS;VITAMINS NOS]). On 12-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. The patient's last menstrual period was on 19-Oct-2020 and the estimated date of delivery was 26-Jul-2021. On 12-Mar-2021, the patient experienced EXPOSURE DURING PREGNANCY (Pregnancy). The patient received mRNA-1273 (Moderna COVID-19 Vaccine) beginning around the twentieth week of the pregnancy. At the time of the report, EXPOSURE DURING PREGNANCY (Pregnancy) outcome was unknown. Not Provided DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 09-Mar-2021, Ultrasound foetal: normal (normal) all were normal. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Prenatal care has been established.

Other Meds: PRENATAL VITAMINS [MINERALS NOS;VITAMINS NOS]

Current Illness:

ID: 1566240
Sex: F
Age: 82
State:

Vax Date: 03/04/2021
Onset Date: 03/11/2021
Rec V Date: 08/15/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Injection site pain

Symptoms: Red itchy bump at the injection site; Red itchy bump at the injection site; Red itchy bump at the injection site; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE MASS (Red itchy bump at the injection site), VACCINATION SITE PRURITUS (Red itchy bump at the injection site) and VACCINATION SITE ERYTHEMA (Red itchy bump at the injection site) in an 82-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 101A21A) for COVID-19 vaccination. No Medical History information was reported. On 04-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 11-Mar-2021, the patient experienced VACCINATION SITE MASS (Red itchy bump at the injection site), VACCINATION SITE PRURITUS (Red itchy bump at the injection site) and VACCINATION SITE ERYTHEMA (Red itchy bump at the injection site). At the time of the report, VACCINATION SITE MASS (Red itchy bump at the injection site), VACCINATION SITE PRURITUS (Red itchy bump at the injection site) and VACCINATION SITE ERYTHEMA (Red itchy bump at the injection site) had not resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Treatment information was not provided. Concomitant medication was not provided.

Other Meds:

Current Illness:

ID: 1566241
Sex: F
Age:
State:

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

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

Lab Data:

Allergies:

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

Symptoms: elevated WBC count one week after the first injection; elevated WBC count one week after the first injection; Based on the current case data, this case has been classified as invalid. This spontaneous case was reported by a consumer and describes the occurrence of THERAPEUTIC RESPONSE UNEXPECTED (elevated WBC count one week after the first injection) and WHITE BLOOD CELL COUNT INCREASED (elevated WBC count one week after the first injection) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced THERAPEUTIC RESPONSE UNEXPECTED (elevated WBC count one week after the first injection) and WHITE BLOOD CELL COUNT INCREASED (elevated WBC count one week after the first injection). At the time of the report, THERAPEUTIC RESPONSE UNEXPECTED (elevated WBC count one week after the first injection) and WHITE BLOOD CELL COUNT INCREASED (elevated WBC count one week after the first injection) outcome was unknown. Not Provided DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, White blood cell count: elevated (High) Elevated WBC count. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Concomitant product were not provided by the reporter. Treatment medication were not reported by the reporter.

Other Meds:

Current Illness:

ID: 1566242
Sex: F
Age: 78
State: NY

Vax Date: 03/08/2021
Onset Date: 03/11/2021
Rec V Date: 08/15/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: dry mouth; discomfort in the mouth; swollen/red gums; tooth aches; tongue is tingling/burning; tongue is tingling/burning; This spontaneous case was reported by a consumer and describes the occurrence of DRY MOUTH (dry mouth), ORAL DISCOMFORT (discomfort in the mouth), GINGIVAL SWELLING (swollen/red gums), TOOTHACHE (tooth aches) and PARAESTHESIA ORAL (tongue is tingling/burning) in a 78-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 036A21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. Concomitant products included SIMVASTATIN (VASTATIN) and OMEPRAZOLE (PRILOSEC [OMEPRAZOLE]) for an unknown indication. On 08-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 11-Mar-2021, the patient experienced DRY MOUTH (dry mouth), ORAL DISCOMFORT (discomfort in the mouth), GINGIVAL SWELLING (swollen/red gums), TOOTHACHE (tooth aches), PARAESTHESIA ORAL (tongue is tingling/burning) and TONGUE DISCOMFORT (tongue is tingling/burning). The patient was treated with ACETYLSALICYLIC ACID (ASPIRIN (E.C.)) for Adverse event, at a dose of 1 dosage form and ETHANOL, THYMOL (LISTERINE ANTISEPTIC MOUTHWASH) ongoing since an unknown date for Adverse event, at a dose of 1 dosage form. At the time of the report, DRY MOUTH (dry mouth), ORAL DISCOMFORT (discomfort in the mouth), GINGIVAL SWELLING (swollen/red gums), TOOTHACHE (tooth aches), PARAESTHESIA ORAL (tongue is tingling/burning) and TONGUE DISCOMFORT (tongue is tingling/burning) had not resolved. Unknown The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Treatment also included rinsing with salt water. Most recent FOLLOW-UP information incorporated above includes: On 22-Jul-2021: Significant follow up appended: Pregnancy status updated and contact information updated.

Other Meds: VASTATIN; PRILOSEC [OMEPRAZOLE]

Current Illness:

ID: 1566243
Sex: F
Age: 41
State: CA

Vax Date: 03/04/2021
Onset Date: 03/12/2021
Rec V Date: 08/15/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Tremor

Symptoms: Fever; Chills; Fatigue; This spontaneous case was reported by a consumer and describes the occurrence of PYREXIA (Fever), CHILLS (Chills) and FATIGUE (Fatigue) in a 41-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. Concurrent medical conditions included Crohn's disease. Concomitant products included USTEKINUMAB (STELARA) for Crohn's disease. On 04-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 12-Mar-2021, the patient experienced PYREXIA (Fever), CHILLS (Chills) and FATIGUE (Fatigue). The patient was treated with PARACETAMOL (TYLENOL) at an unspecified dose and frequency. At the time of the report, PYREXIA (Fever), CHILLS (Chills) and FATIGUE (Fatigue) had not resolved. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 12-Mar-2021, Body temperature: 99 (High) 99 F. On 13-Mar-2021, Body temperature: 99 (High) 99 F. 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: STELARA

Current Illness: Crohn's disease

ID: 1566244
Sex: F
Age:
State:

Vax Date: 02/12/2021
Onset Date: 03/12/2021
Rec V Date: 08/15/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Erythema, Pruritus

Symptoms: Body aches; Fever; Chills; Joint pain; This spontaneous case was reported by a consumer and describes the occurrence of PAIN (Body aches), PYREXIA (Fever), CHILLS (Chills) and ARTHRALGIA (Joint pain) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 027L20A and 027L20A) for COVID-19 vaccination. No Medical History information was reported. On 12-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 11-Mar-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 12-Mar-2021, after starting mRNA-1273 (Moderna COVID-19 Vaccine), the patient experienced PAIN (Body aches). 12-Mar-2021, the patient experienced PYREXIA (Fever), CHILLS (Chills) and ARTHRALGIA (Joint pain). At the time of the report, PAIN (Body aches), PYREXIA (Fever), CHILLS (Chills) and ARTHRALGIA (Joint pain) outcome was unknown. No relevant concomitant medication was reported. Treatment information was not provided Reporter did not allow further contact

Other Meds:

Current Illness:

ID: 1566245
Sex: F
Age: 81
State: ME

Vax Date: 03/12/2021
Onset Date: 03/12/2021
Rec V Date: 08/15/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: sore; tired; arm hurt a little bit; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (arm hurt a little bit), PAIN (sore) and FATIGUE (tired) in an 81-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 004A21A) for COVID-19 vaccination. No medical history was provided by the reporter. Concomitant products included APIXABAN (ELIQUIS), LISINOPRIL, METOPROLOL, SITAGLIPTIN PHOSPHATE (JANUVIA), VITAMIN D2, DIAZEPAM and LEVOTHYROXINE for an unknown indication. On 12-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 12-Mar-2021, the patient experienced PAIN IN EXTREMITY (arm hurt a little bit). On 13-Mar-2021, the patient experienced PAIN (sore) and FATIGUE (tired). At the time of the report, PAIN IN EXTREMITY (arm hurt a little bit), PAIN (sore) and FATIGUE (tired) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. Patient was taking blood thinners. No treatment medicines were provided.

Other Meds: ELIQUIS; LISINOPRIL; METOPROLOL; JANUVIA; VITAMIN D2; DIAZEPAM; LEVOTHYROXINE

Current Illness:

ID: 1566246
Sex: F
Age: 71
State: AL

Vax Date: 03/05/2021
Onset Date: 03/06/2021
Rec V Date: 08/15/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: whole left arm from the shoulder where she got the shot was hot and it run down the whole side of her body until her ankle; in her ankle she had a round spot on the side; She had pain in her whole left arm from the shoulder where she got the shot and down the whole side of her body until her ankle; This spontaneous case was reported by a consumer and describes the occurrence of FEELING HOT (whole left arm from the shoulder where she got the shot was hot and it run down the whole side of her body until her ankle), VACCINATION SITE REACTION (in her ankle she had a round spot on the side) and PAIN (She had pain in her whole left arm from the shoulder where she got the shot and down the whole side of her body until her ankle) in a 71-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 030M29A) for COVID-19 vaccination. Concurrent medical conditions included Arthritis and Back pain. On 05-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 06-Mar-2021, the patient experienced FEELING HOT (whole left arm from the shoulder where she got the shot was hot and it run down the whole side of her body until her ankle), VACCINATION SITE REACTION (in her ankle she had a round spot on the side) and PAIN (She had pain in her whole left arm from the shoulder where she got the shot and down the whole side of her body until her ankle). On 07-Mar-2021, FEELING HOT (whole left arm from the shoulder where she got the shot was hot and it run down the whole side of her body until her ankle), VACCINATION SITE REACTION (in her ankle she had a round spot on the side) and PAIN (She had pain in her whole left arm from the shoulder where she got the shot and down the whole side of her body until her ankle) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No relevant concomitant medication was reported. Treatment information was not provided.

Other Meds:

Current Illness: Arthritis; Back pain

ID: 1566247
Sex: F
Age:
State:

Vax Date: 03/13/2021
Onset Date: 03/13/2021
Rec V Date: 08/15/2021
Hospital:

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

Allergies:

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Sore arm at the injection site; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE PAIN (Sore arm at the injection site) 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 13-Mar-2021, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 13-Mar-2021, the patient experienced VACCINATION SITE PAIN (Sore arm at the injection site). On 14-Mar-2021, VACCINATION SITE PAIN (Sore arm at the injection site) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant medications were reported. No Treatments were reported. This case was linked to MOD-2021-045641 (E2B Linked Report).; Sender's Comments: MOD-2021-045641:same reporter and two patients mentioned in source document. one case is processed in ICSR ID MOD-2021-045641

Other Meds:

Current Illness:

ID: 1566248
Sex: F
Age:
State: NV

Vax Date: 01/16/2021
Onset Date: 02/13/2021
Rec V Date: 08/15/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Sore shot arms; achy; tired; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (Sore shot arms), PAIN (achy) and FATIGUE (tired) 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 16-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 13-Feb-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 13-Feb-2021, the patient experienced PAIN IN EXTREMITY (Sore shot arms), PAIN (achy) and FATIGUE (tired). At the time of the report, PAIN IN EXTREMITY (Sore shot arms), PAIN (achy) and FATIGUE (tired) outcome was unknown. No Treatment medications was available. No concomitant medications was available.

Other Meds:

Current Illness:

ID: 1566249
Sex: M
Age: 85
State: MD

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

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

Lab Data:

Allergies:

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

Symptoms: sore arm; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (sore arm) in an 86-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 023M20A) for COVID-19 vaccination. No Medical History information was reported. 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 PAIN IN EXTREMITY (sore arm). On 16-Feb-2021, PAIN IN EXTREMITY (sore arm) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Concomitant and Treatment medications were not provided by reporter.

Other Meds:

Current Illness:

ID: 1566250
Sex: M
Age:
State: NV

Vax Date: 01/16/2021
Onset Date: 02/13/2021
Rec V Date: 08/15/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Pain in extremity

Symptoms: diarrhea; tired; sore shot arm; achy; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (sore shot arm), PAIN (achy), DIARRHOEA (diarrhea) and FATIGUE (tired) in a male patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. Patient has sensitive stomach and gets diarrhea from eating too much beef, fish, diary products. The patient's past medical history included Heart attack in 2015, Diverticulitis, Intestinal resection, Hartmann's pouch procedure in 2016 and Stent placement in 2015. Concurrent medical conditions included Type 2 diabetes mellitus, Stomach ache, Food allergy (Beef), Fish allergy and Dairy free diet. On 16-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 13-Feb-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 13-Feb-2021, the patient experienced PAIN IN EXTREMITY (sore shot arm), PAIN (achy) and FATIGUE (tired). On an unknown date, the patient experienced DIARRHOEA (diarrhea). At the time of the report, PAIN IN EXTREMITY (sore shot arm), PAIN (achy), DIARRHOEA (diarrhea) and FATIGUE (tired) outcome was unknown. No treatment details were provided. patient's diarrhea was yellow and smelly and severe This case was linked to MOD-2021-020083 (Patient Link).

Other Meds:

Current Illness: Dairy free diet; Fish allergy; Food allergy (Beef); Stomach ache; Type 2 diabetes mellitus

ID: 1566251
Sex: F
Age:
State: MA

Vax Date: 03/09/2021
Onset Date: 03/09/2021
Rec V Date: 08/15/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Tinnitus; This spontaneous case was reported by a consumer and describes the occurrence of TINNITUS (Tinnitus) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 036A21A) for COVID-19 vaccination. Concurrent medical conditions included Allergy to antibiotic (Allergy to Keflex) and Blood pressure. On 09-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 09-Mar-2021, the patient experienced TINNITUS (Tinnitus). The patient was treated with DIPHENHYDRAMINE HYDROCHLORIDE (BENADRYL [DIPHENHYDRAMINE HYDROCHLORIDE]) for Adverse event, at a dose of UNK dosage form. At the time of the report, TINNITUS (Tinnitus) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Concomitant products included blood pressure medications (unspecified). Most recent FOLLOW-UP information incorporated above includes: On 22-Jul-2021: Outcome of the event Tinnitus was changed from Unknown to recovered.

Other Meds:

Current Illness: Allergy to antibiotic (Allergy to Keflex); Blood pressure

ID: 1566252
Sex: F
Age: 66
State: FL

Vax Date: 02/12/2021
Onset Date: 03/12/2021
Rec V Date: 08/15/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: warmth at injection site; rash around the hand; fever; rash at injection site; swelling at injection site; arm began feeling sore; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (arm began feeling sore), VACCINATION SITE WARMTH (warmth at injection site), RASH (rash around the hand), PYREXIA (fever) and VACCINATION SITE RASH (rash at injection site) in a 66-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 027A210A and 015M20A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 12-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 12-Mar-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 12-Mar-2021, after starting mRNA-1273 (Moderna COVID-19 Vaccine), the patient experienced PAIN IN EXTREMITY (arm began feeling sore). On 13-Mar-2021, the patient experienced VACCINATION SITE WARMTH (warmth at injection site), RASH (rash around the hand), PYREXIA (fever), VACCINATION SITE RASH (rash at injection site) and VACCINATION SITE SWELLING (swelling at injection site). The patient was treated with IBUPROFEN (ADVIL [IBUPROFEN]) for Pain and Fever, at an unspecified dose and frequency and DIPHENHYDRAMINE HYDROCHLORIDE (BENADRYL [DIPHENHYDRAMINE HYDROCHLORIDE]) for Rash, at an unspecified dose and frequency. On 13-Mar-2021, PYREXIA (fever) had resolved. On 14-Mar-2021, RASH (rash around the hand) had resolved. At the time of the report, PAIN IN EXTREMITY (arm began feeling sore) had not resolved and VACCINATION SITE WARMTH (warmth at injection site), VACCINATION SITE RASH (rash at injection site) and VACCINATION SITE SWELLING (swelling at injection site) outcome was unknown. No relevant concomitant medications were provided. The action taken for mRNA-1273 was not applicable. This case was linked to MOD-2021-015296 (Patient Link).

Other Meds:

Current Illness:

ID: 1566253
Sex: M
Age: 65
State: AZ

Vax Date: 01/11/2021
Onset Date:
Rec V Date: 08/15/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: negative antibody test; This spontaneous case was reported by a health care professional and describes the occurrence of ANTIBODY TEST NEGATIVE (negative antibody test) in a 66-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 11-Jan-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 08-Feb-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On an unknown date, the patient experienced ANTIBODY TEST NEGATIVE (negative antibody test). At the time of the report, ANTIBODY TEST NEGATIVE (negative antibody test) outcome was unknown. Unknown For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. Concomitant medication information is not provided. Treatment is not given for the event.

Other Meds:

Current Illness:

ID: 1566254
Sex: F
Age:
State: IN

Vax Date: 03/12/2021
Onset Date: 03/12/2021
Rec V Date: 08/15/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Vomiting

Symptoms: itchy throat; headache; This spontaneous case was reported by a nurse (subsequently medically confirmed) and describes the occurrence of THROAT IRRITATION (itchy throat) and HEADACHE (headache) in a 40-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 011J20A) for COVID-19 vaccination. No medical history was provided by the reporter. On 12-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 12-Mar-2021, the patient experienced THROAT IRRITATION (itchy throat) and HEADACHE (headache). At the time of the report, THROAT IRRITATION (itchy throat) and HEADACHE (headache) 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 considered THROAT IRRITATION (itchy throat) and HEADACHE (headache) to be probably related. No concomitant product was reported. Patient's treatment information include Benadryl 25 mg po. She was monitored an additional 30 minutes at which time, she was doing well and instructed to follow-up with our onsite nurse as needed. Most recent FOLLOW-UP information incorporated above includes: On 07-May-2021: Follow up was received on 07 may 2021 included no new information.

Other Meds:

Current Illness:

ID: 1566255
Sex: M
Age: 51
State: NY

Vax Date: 03/05/2021
Onset Date: 03/06/2021
Rec V Date: 08/15/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: excruciating kidney pain; couldn't stand up straight had to walk at 45 degree angle, totally bent over, in agony, as if someone was pulling out my kidneys; fluid in throat was so thick I couldn't expel it; This spontaneous case was reported by a consumer and describes the occurrence of RENAL PAIN (excruciating kidney pain), POSTURE ABNORMAL (couldn't stand up straight had to walk at 45 degree angle, totally bent over, in agony, as if someone was pulling out my kidneys) and OROPHARYNGEAL DISCOMFORT (fluid in throat was so thick I couldn't expel it) in a 51-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 05-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 06-Mar-2021, the patient experienced RENAL PAIN (excruciating kidney pain), POSTURE ABNORMAL (couldn't stand up straight had to walk at 45 degree angle, totally bent over, in agony, as if someone was pulling out my kidneys) and OROPHARYNGEAL DISCOMFORT (fluid in throat was so thick I couldn't expel it). At the time of the report, RENAL PAIN (excruciating kidney pain) and OROPHARYNGEAL DISCOMFORT (fluid in throat was so thick I couldn't expel it) had not resolved and POSTURE ABNORMAL (couldn't stand up straight had to walk at 45 degree angle, totally bent over, in agony, as if someone was pulling out my kidneys) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medication details was reported. No treatment medication details was reported.

Other Meds:

Current Illness:

ID: 1566256
Sex: F
Age:
State: NJ

Vax Date: 03/12/2021
Onset Date: 03/12/2021
Rec V Date: 08/15/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Sore arm; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (Sore arm) in a 62-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. Concurrent medical conditions included No adverse event. On 12-Mar-2021, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 12-Mar-2021, the patient experienced PAIN IN EXTREMITY (Sore arm). At the time of the report, PAIN IN EXTREMITY (Sore arm) outcome was unknown. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Concomitant medication list was not provided. Treatment information was not provided.

Other Meds:

Current Illness:

ID: 1566257
Sex: F
Age:
State:

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

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

Lab Data:

Allergies:

Symptom List: Injection site swelling, Limb discomfort

Symptoms: dx with shingles; Sore throat; Very sore arm; Felt unwell; "Weird" headache; This spontaneous case was reported by a non-health professional and describes the occurrence of HERPES ZOSTER (dx with shingles), OROPHARYNGEAL PAIN (Sore throat), PAIN IN EXTREMITY (Very sore arm), MALAISE (Felt unwell) and HEADACHE ("Weird" headache) in a 70-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) (unknown route) 1 dosage form. On an unknown date, the patient experienced HERPES ZOSTER (dx with shingles), OROPHARYNGEAL PAIN (Sore throat), PAIN IN EXTREMITY (Very sore arm), MALAISE (Felt unwell) and HEADACHE ("Weird" headache). At the time of the report, HERPES ZOSTER (dx with shingles), OROPHARYNGEAL PAIN (Sore throat), PAIN IN EXTREMITY (Very sore arm), MALAISE (Felt unwell) and HEADACHE ("Weird" headache) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant medications were provided. Treatment medications were unknown.

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Current Illness:

ID: 1566258
Sex: F
Age: 56
State:

Vax Date: 03/03/2020
Onset Date: 03/03/2021
Rec V Date: 08/15/2021
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Allergies:

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

Symptoms: Arm Soreness; Headache; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (Arm Soreness) and HEADACHE (Headache) in a 57-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 025A21A) for COVID-19 vaccination. Concurrent medical conditions included Diabetes, Blood cholesterol abnormal and Blood pressure abnormal. On 03-Mar-2020, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) at an unspecified dose. On 03-Mar-2021, the patient experienced PAIN IN EXTREMITY (Arm Soreness) and HEADACHE (Headache). On 04-Mar-2021, PAIN IN EXTREMITY (Arm Soreness) and HEADACHE (Headache) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown Route) was unknown. Concomitantly the patient was receiving unspecified diabetes medication, cholesterol medication and blood pressure medication. The patient did not receive any treatment for these events.

Other Meds:

Current Illness: Blood cholesterol abnormal; Blood pressure abnormal; Diabetes

ID: 1566259
Sex: F
Age: 78
State: GA

Vax Date: 02/09/2021
Onset Date: 03/09/2021
Rec V Date: 08/15/2021
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Symptom List: Hot flush, Myalgia, Nausea, Tension headache

Symptoms: Itchy on arms; Arm is aching; Rash on arm, breaking out on both of her arms; This spontaneous case was reported by a consumer and describes the occurrence of PRURITUS (Itchy on arms), PAIN IN EXTREMITY (Arm is aching) and RASH (Rash on arm, breaking out on both of her arms) in a 78-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 044A21A and 012M20A) for COVID-19 vaccination. Concurrent medical conditions included Psoriasis. Concomitant products included AMLODIPINE, HYDROCHLOROTHIAZIDE, VENLAFAXINE and OMEPRAZOLE for an unknown indication. On 09-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 09-Mar-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 09-Mar-2021, the patient experienced PRURITUS (Itchy on arms), PAIN IN EXTREMITY (Arm is aching) and RASH (Rash on arm, breaking out on both of her arms). The patient was treated with METHYLPREDNISOLONE at an unspecified dose and frequency and COCONUT OIL on 14-Mar-2021 at an unspecified dose and frequency. At the time of the report, PRURITUS (Itchy on arms) had resolved and PAIN IN EXTREMITY (Arm is aching) and RASH (Rash on arm, breaking out on both of her arms) outcome was unknown. Action taken with mRNA-1273 in response to the events was not applicable. Treatment included unspecified prescription cream that kind of burned her arm so she stopped that. The patient said that she had a treatment done for her psoriasis prior to receiving first vaccine dose on 9Feb2021 and was given a cream to put on in the infected places. The patient is due for a steroid shot.

Other Meds: AMLODIPINE; HYDROCHLOROTHIAZIDE; VENLAFAXINE; OMEPRAZOLE

Current Illness: Psoriasis

Total 2021 VAERS Injuries: 704,237

Page last modified: 26 October 2021 2:21am