VAERS 2021 Database www.vaers.hhs.gov

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

Total Manufacturer

Incidents per State

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

ID: 1570973
Sex: F
Age:
State: MI

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

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Symptoms: covid arm; This spontaneous case was reported by a physician and describes the occurrence of VACCINATION SITE REACTION (covid arm) 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 03-Mar-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 REACTION (covid arm). At the time of the report, VACCINATION SITE REACTION (covid 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. No Concomitant medications was reported Treatment information was not provided

Other Meds:

Current Illness:

ID: 1570974
Sex: F
Age:
State: NV

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

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Symptom List:

Symptoms: Sore arm; The muscle is swollen; It's kind of heated up; Tired; Arm pain / Really bad; Kept her up at night; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (Arm pain / Really bad), INSOMNIA (Kept her up at night), PAIN IN EXTREMITY (Sore arm), MUSCLE SWELLING (The muscle is swollen) and FEELING HOT (It's kind of heated up) in a 75-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No medical history was reported by the reporter. Concomitant products included METOPROLOL, ATORVASTATIN and RIVAROXABAN (XARELTO) for an unknown indication. On 11-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 PAIN IN EXTREMITY (Arm pain / Really bad), INSOMNIA (Kept her up at night) and FATIGUE (Tired). On 20-Mar-2021, the patient experienced PAIN IN EXTREMITY (Sore arm), MUSCLE SWELLING (The muscle is swollen) and FEELING HOT (It's kind of heated up). The patient was treated with DICLOFENAC (VOLTAREN [DICLOFENAC]) at a dose of 1 dosage form and PARACETAMOL (TYLENOL) at a dose of 1 dosage form. On 12-Mar-2021, PAIN IN EXTREMITY (Arm pain / Really bad) and INSOMNIA (Kept her up at night) had resolved. At the time of the report, PAIN IN EXTREMITY (Sore arm), MUSCLE SWELLING (The muscle is swollen), FEELING HOT (It's kind of heated up) and FATIGUE (Tired) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Concomitant medications also include OTC allergy medication. Most recent FOLLOW-UP information incorporated above includes: On 10-May-2021: Event Outcome: From unknown to recovered updated.

Other Meds: METOPROLOL; ATORVASTATIN; XARELTO

Current Illness:

ID: 1570975
Sex: F
Age: 60
State: FL

Vax Date: 03/15/2021
Onset Date:
Rec V Date: 08/15/2021
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Symptoms: very very very sick with it/ sicker than when I was with COVID; fever for 3 days, close to 102; This spontaneous case was reported by a consumer and describes the occurrence of ILLNESS (very very very sick with it/ sicker than when I was with COVID) and PYREXIA (fever for 3 days, close to 102) in a 60-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 COVID-19 on 27-Feb-2021. Concomitant products included TIOTROPIUM BROMIDE MONOHYDRATE (SPIRIVA) for an unknown indication. On 15-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On an unknown date, the patient experienced ILLNESS (very very very sick with it/ sicker than when I was with COVID) and PYREXIA (fever for 3 days, close to 102). The patient was treated with PARACETAMOL (TYLENOL) at an unspecified dose and frequency. At the time of the report, ILLNESS (very very very sick with it/ sicker than when I was with COVID) and PYREXIA (fever for 3 days, close to 102) outcome was unknown. Not Provided DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 27-Feb-2021, SARS-CoV-2 antibody test: positive (Positive) Positive. On an unknown date, Body temperature: 102 (High) had fever for 3 days. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Concomitant medication taken by the patient included hormone cream.

Other Meds: SPIRIVA

Current Illness:

ID: 1570976
Sex: F
Age: 36
State: CO

Vax Date: 03/09/2021
Onset Date: 03/16/2021
Rec V Date: 08/15/2021
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Symptoms: Ring-like appearance around the area; Large that looked like fat deposits under the armpit of the same arm under the vaccination area; Floaters on the eye; Extremely fatigue; Red, swollen, and itchy rash; Red, swollen, and itchy rash; Red, swollen, and itchy rash; This spontaneous case was reported by a consumer and describes the occurrence of VITREOUS FLOATERS (Floaters on the eye), RASH PRURITIC (Red, swollen, and itchy rash), VACCINATION SITE REACTION (Ring-like appearance around the area), VACCINATION SITE MASS (Large that looked like fat deposits under the armpit of the same arm under the vaccination area) and VACCINATION SITE SWELLING (Red, swollen, and itchy rash) in a 37-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. No medical history was provided by the reporter. Concomitant products included TOPIRAMATE (TOPAMAX) and ATORVASTATIN for an unknown indication. On 09-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 16-Mar-2021, the patient experienced RASH PRURITIC (Red, swollen, and itchy rash), VACCINATION SITE SWELLING (Red, swollen, and itchy rash) and VACCINATION SITE ERYTHEMA (Red, swollen, and itchy rash). On an unknown date, the patient experienced VITREOUS FLOATERS (Floaters on the eye), VACCINATION SITE REACTION (Ring-like appearance around the area), VACCINATION SITE MASS (Large that looked like fat deposits under the armpit of the same arm under the vaccination area) and FATIGUE (Extremely fatigue). The patient was treated with DIPHENHYDRAMINE HYDROCHLORIDE (BENADRYL [DIPHENHYDRAMINE HYDROCHLORIDE]) at a dose of 1 dosage form as required. On 22-Mar-2021, FATIGUE (Extremely fatigue) was resolving. At the time of the report, VITREOUS FLOATERS (Floaters on the eye), RASH PRURITIC (Red, swollen, and itchy rash), VACCINATION SITE REACTION (Ring-like appearance around the area), VACCINATION SITE MASS (Large that looked like fat deposits under the armpit of the same arm under the vaccination area), VACCINATION SITE SWELLING (Red, swollen, and itchy rash) and VACCINATION SITE ERYTHEMA (Red, swollen, and itchy rash) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Concomitant medication also included an intra uterine device for birth control NOS. Treatment medication also included some anti-inflammatory medication like NSAIDs which were NOS.

Other Meds: TOPAMAX; ATORVASTATIN

Current Illness:

ID: 1570977
Sex: F
Age:
State: CT

Vax Date: 02/27/2021
Onset Date: 03/10/2021
Rec V Date: 08/15/2021
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Symptoms: Tested positive on Covid, the disease; This spontaneous case was reported by a consumer and describes the occurrence of ASYMPTOMATIC COVID-19 (Tested positive on Covid, the disease) 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 27-Feb-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 ASYMPTOMATIC COVID-19 (Tested positive on Covid, the disease). At the time of the report, ASYMPTOMATIC COVID-19 (Tested positive on Covid, the disease) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 10-Mar-2021, SARS-CoV-2 test: positive (Positive) Positive. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No Concomitant medications was reported Treatment information was not provided

Other Meds:

Current Illness:

ID: 1570978
Sex: F
Age: 29
State: NY

Vax Date: 03/18/2021
Onset Date: 03/18/2021
Rec V Date: 08/15/2021
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Symptoms: lots of sleep; dizziness; short of breath; feeling lots of malaise; fever; headache; lots of chills; lots of tirednessand fatigue; This spontaneous case was reported by a patient and describes the occurrence of HYPERSOMNIA (lots of sleep), DIZZINESS (dizziness), DYSPNOEA (short of breath), MALAISE (feeling lots of malaise) and PYREXIA (fever) in a 29-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 047A21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 18-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 18-Mar-2021, the patient experienced HYPERSOMNIA (lots of sleep), DIZZINESS (dizziness), DYSPNOEA (short of breath), MALAISE (feeling lots of malaise), PYREXIA (fever), HEADACHE (headache), CHILLS (lots of chills) and FATIGUE (lots of tirednessand fatigue). The patient was treated with PARACETAMOL (TYLENOL) at an unspecified dose and frequency and IBUPROFEN (ADVIL 12 HOUR) at an unspecified dose and frequency. At the time of the report, HYPERSOMNIA (lots of sleep), DIZZINESS (dizziness), DYSPNOEA (short of breath), MALAISE (feeling lots of malaise), PYREXIA (fever), HEADACHE (headache), CHILLS (lots of chills) and FATIGUE (lots of tirednessand fatigue) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. Concomitant medications included inhaler for asthma

Other Meds:

Current Illness:

ID: 1570979
Sex: F
Age: 69
State: MI

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

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Symptoms: root canal; facial swelling; This spontaneous case was reported by a consumer and describes the occurrence of ROOT CANAL INFECTION (root canal) and SWELLING FACE (facial swelling) in a 69-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 015M20A) 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) (unknown route) 1 dosage form. On 02-Mar-2021, the patient experienced ROOT CANAL INFECTION (root canal) and SWELLING FACE (facial swelling). The patient was treated with PREDNISONE at an unspecified dose and frequency. At the time of the report, ROOT CANAL INFECTION (root canal) and SWELLING FACE (facial swelling) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant medications were provided by the reporter. The patient was treated with antibiotics(ongoing).

Other Meds:

Current Illness:

ID: 1570980
Sex: F
Age: 94
State: MI

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

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Symptoms: fatigue; This spontaneous case was reported by a consumer and describes the occurrence of FATIGUE (fatigue) in a 94-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 23-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 FATIGUE (fatigue). At the time of the report, FATIGUE (fatigue) outcome was unknown. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Concomitant medications included unspecified thyroid medication and blood pressure medication. Treatment Medications were not provided by the reporter.

Other Meds:

Current Illness:

ID: 1570981
Sex: F
Age:
State:

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

Vax Type:
Manufacturer:
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Lab Data:

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Symptom List:

Symptoms: Spinal pain; This spontaneous case was reported by a consumer and describes the occurrence of SPINAL PAIN (Spinal pain) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 023M20A) for COVID-19 vaccination. No Medical History information was reported. On 02-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On an unknown date, the patient experienced SPINAL PAIN (Spinal pain). At the time of the report, SPINAL PAIN (Spinal pain) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medications were reported. Treatment information was not provided. Reporter did not allow further contact

Other Meds:

Current Illness:

ID: 1570982
Sex: F
Age: 87
State: FL

Vax Date: 01/25/2021
Onset Date: 02/23/2021
Rec V Date: 08/15/2021
Hospital:

Vax Type:
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Symptom List:

Symptoms: her hands and feet were so cold; 101 temperature; Tired; Little Headache; Chills; This spontaneous case was reported by a consumer and describes the occurrence of PERIPHERAL COLDNESS (her hands and feet were so cold), PYREXIA (101 temperature), FATIGUE (Tired), HEADACHE (Little Headache) and CHILLS (Chills) in an 87-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 013M20A and 030L20A) for COVID-19 vaccination. No Medical History information was reported. On 25-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 22-Feb-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 23-Feb-2021, the patient experienced PERIPHERAL COLDNESS (her hands and feet were so cold), PYREXIA (101 temperature), FATIGUE (Tired), HEADACHE (Little Headache) and CHILLS (Chills). At the time of the report, PERIPHERAL COLDNESS (her hands and feet were so cold), PYREXIA (101 temperature), FATIGUE (Tired), HEADACHE (Little Headache) and CHILLS (Chills) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 23-Feb-2021, Body temperature: 101 (Inconclusive) 101 temperature. On 10-Mar-2021, Granulocyte count: high (High) high. On 10-Mar-2021, Monocyte count: high (High) high. No Concomitant medications was reported Treatment information was not provided

Other Meds:

Current Illness:

ID: 1570983
Sex: F
Age: 69
State:

Vax Date: 03/17/2021
Onset Date: 03/17/2021
Rec V Date: 08/15/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: hardness, itching, redness and swelling; hardness, itching, redness and swelling; hardness, itching, redness and swelling; hardness, itching, redness and swelling; This spontaneous case was reported by a consumer and describes the occurrence of INDURATION (hardness, itching, redness and swelling), PRURITUS (hardness, itching, redness and swelling), ERYTHEMA (hardness, itching, redness and swelling) and SWELLING (hardness, itching, redness and swelling) in a 69-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 044a21a) for COVID-19 vaccination. No Medical History information was reported. On 17-Mar-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 17-Mar-2021, the patient experienced INDURATION (hardness, itching, redness and swelling), PRURITUS (hardness, itching, redness and swelling), ERYTHEMA (hardness, itching, redness and swelling) and SWELLING (hardness, itching, redness and swelling). At the time of the report, INDURATION (hardness, itching, redness and swelling), PRURITUS (hardness, itching, redness and swelling), ERYTHEMA (hardness, itching, redness and swelling) and SWELLING (hardness, itching, redness and swelling) outcome was unknown. No Concomitant medications was reported Treatment information was not provided

Other Meds:

Current Illness:

ID: 1570984
Sex: F
Age: 66
State: IA

Vax Date: 02/11/2021
Onset Date: 02/21/2021
Rec V Date: 08/15/2021
Hospital:

Vax Type:
Manufacturer:
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Lab Data:

Allergies:

Symptom List:

Symptoms: right arm from shoulder to elbow got swollen; right arm from shoulder to elbow got hot; right arm from shoulder to elbow got red; right arm from shoulder to elbow got tender; right arm from shoulder to elbow got itchy; This spontaneous case was reported by a consumer and describes the occurrence of PERIPHERAL SWELLING (right arm from shoulder to elbow got swollen), FEELING HOT (right arm from shoulder to elbow got hot), ERYTHEMA (right arm from shoulder to elbow got red), TENDERNESS (right arm from shoulder to elbow got tender) and PRURITUS (right arm from shoulder to elbow got itchy) in a 66-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 031L20A) for COVID-19 vaccination. Concomitant products included CYCLOBENZAPRINE HYDROCHLORIDE (FLEXERIL [CYCLOBENZAPRINE HYDROCHLORIDE]) and OXYBUTYNIN HYDROCHLORIDE (OXYBUTIN) for an unknown indication. On 11-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 21-Feb-2021, the patient experienced PERIPHERAL SWELLING (right arm from shoulder to elbow got swollen), FEELING HOT (right arm from shoulder to elbow got hot), ERYTHEMA (right arm from shoulder to elbow got red), TENDERNESS (right arm from shoulder to elbow got tender) and PRURITUS (right arm from shoulder to elbow got itchy). The patient was treated with DIPHENHYDRAMINE HYDROCHLORIDE (BENADRYL ALLERGY [DIPHENHYDRAMINE HYDROCHLORIDE]) ongoing since an unknown date for Adverse event, at an unspecified dose and frequency. At the time of the report, PERIPHERAL SWELLING (right arm from shoulder to elbow got swollen), FEELING HOT (right arm from shoulder to elbow got hot), ERYTHEMA (right arm from shoulder to elbow got red), TENDERNESS (right arm from shoulder to elbow got tender) and PRURITUS (right arm from shoulder to elbow got itchy) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. The patient reported the events lasted for over a week.

Other Meds: FLEXERIL [CYCLOBENZAPRINE HYDROCHLORIDE]; OXYBUTIN

Current Illness:

ID: 1570985
Sex: F
Age: 60
State: IN

Vax Date: 02/27/2021
Onset Date: 03/06/2021
Rec V Date: 08/15/2021
Hospital:

Vax Type:
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Symptom List:

Symptoms: shingles; circles on her chest; Covid arm; stiffness; soreness; raised red rash that is circular and itchy; raised red rash that is circular and itchy; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE REACTION (Covid arm), MUSCULOSKELETAL STIFFNESS (stiffness), PAIN (soreness), RASH PRURITIC (raised red rash that is circular and itchy) and ERYTHEMA (raised red rash that is circular and itchy) in a 61-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. The patient's past medical history included Primary sclerosing cholangitis (liver disease). Concomitant products included URSODIOL and ALENDRONATE SODIUM (ALENDRONATE) for an unknown indication. On 27-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 VACCINATION SITE REACTION (Covid arm), MUSCULOSKELETAL STIFFNESS (stiffness), PAIN (soreness), RASH PRURITIC (raised red rash that is circular and itchy) and ERYTHEMA (raised red rash that is circular and itchy). On 13-Mar-2021, the patient experienced RASH (circles on her chest). On 20-Mar-2021, the patient experienced HERPES ZOSTER (shingles). At the time of the report, VACCINATION SITE REACTION (Covid arm), MUSCULOSKELETAL STIFFNESS (stiffness), PAIN (soreness), RASH PRURITIC (raised red rash that is circular and itchy), ERYTHEMA (raised red rash that is circular and itchy), HERPES ZOSTER (shingles) and RASH (circles on her chest) outcome was unknown. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No treatment information was provided.

Other Meds: URSODIOL; ALENDRONATE

Current Illness:

ID: 1570986
Sex: F
Age: 21
State:

Vax Date: 01/11/2021
Onset Date: 01/10/2021
Rec V Date: 08/15/2021
Hospital:

Vax Type:
Manufacturer:
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Symptom List:

Symptoms: the only thing was the sore arm; This spontaneous case was reported by an other health care professional and describes the occurrence of PAIN IN EXTREMITY (the only thing was the sore arm) in a 22-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 03ML20A) for COVID-19 vaccination. No Medical History information was reported. On 11-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 09-Feb-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to at an unspecified dose. On 10-Jan-2021, the patient experienced PAIN IN EXTREMITY (the only thing was the sore arm). At the time of the report, PAIN IN EXTREMITY (the only thing was the sore arm) outcome was unknown. mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosing remained unchanged. Concomitant medications were not reported. Treatment details were not provided. Action taken with mRNA-123 is not applicable. This case was linked to MOD-2021-034443 (Patient Link). Reporter did not allow further contact

Other Meds:

Current Illness:

ID: 1570987
Sex: F
Age: 85
State: NJ

Vax Date: 03/22/2021
Onset Date: 03/23/2021
Rec V Date: 08/15/2021
Hospital:

Vax Type:
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Vax Name:
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Vax Site:

Lab Data:

Allergies:

Symptom List:

Symptoms: Redness on her arm; Cramps; Diarrhea; Nausea; This spontaneous case was reported by a consumer and describes the occurrence of ERYTHEMA (Redness on her arm), MUSCLE SPASMS (Cramps), DIARRHOEA (Diarrhea) and NAUSEA (Nausea) in an 85-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. Concurrent medical conditions included Cholesterol. Concomitant products included ACETYLSALICYLIC ACID (BAYER ASPIRIN) for an unknown indication. On 22-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 23-Mar-2021, the patient experienced ERYTHEMA (Redness on her arm), MUSCLE SPASMS (Cramps), DIARRHOEA (Diarrhea) and NAUSEA (Nausea). At the time of the report, ERYTHEMA (Redness on her arm), MUSCLE SPASMS (Cramps), DIARRHOEA (Diarrhea) and NAUSEA (Nausea) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Concomitant medications also included unspecified cholesterol medications. No treatment information was provided. This case was linked to MOD-2021-083661 (Patient Link).

Other Meds: BAYER ASPIRIN

Current Illness: Cholesterol

ID: 1570988
Sex: M
Age: 66
State: NJ

Vax Date: 02/05/2021
Onset Date: 02/05/2021
Rec V Date: 08/15/2021
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Symptoms: Headache; Chills; Nausea; Fatigue; Tender; Heat sensation in arm; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE WARMTH (Heat sensation in arm), HEADACHE (Headache), CHILLS (Chills), NAUSEA (Nausea) and FATIGUE (Fatigue) in a 66-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 039K20A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. Concurrent medical conditions included Drug allergy (severe allergy with Tylenol with codeine). On 05-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 05-Feb-2021, the patient experienced VACCINATION SITE WARMTH (Heat sensation in arm), CHILLS (Chills), NAUSEA (Nausea), FATIGUE (Fatigue) and VACCINATION SITE PAIN (Tender). On 06-Feb-2021, the patient experienced HEADACHE (Headache). At the time of the report, VACCINATION SITE WARMTH (Heat sensation in arm), HEADACHE (Headache), CHILLS (Chills), NAUSEA (Nausea), FATIGUE (Fatigue) and VACCINATION SITE PAIN (Tender) 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. This case was linked to US-MODERNATX, INC.-MOD-2021-062524 (E2B Linked Report).; Sender's Comments: US-MODERNATX, INC.-MOD-2021-062524:case for dose 2

Other Meds:

Current Illness: Drug allergy (severe allergy with Tylenol with codeine)

ID: 1570989
Sex: F
Age:
State: NV

Vax Date:
Onset Date:
Rec V Date: 08/15/2021
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Symptoms: vasculitis; had a sore arm; she developed a rash on both of her legs; Lesions on both legs, non -itchy.; This spontaneous case was reported by a consumer and describes the occurrence of VASCULITIS (vasculitis), PAIN IN EXTREMITY (had a sore arm), RASH (she developed a rash on both of her legs) and SKIN LESION (Lesions on both legs, non -itchy.) in a 67-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 011A21A) for COVID-19 vaccination. No medical history reported. Concomitant products included LEVOTHYROXINE SODIUM (SYNTHROID) for an unknown indication. 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 VASCULITIS (vasculitis), PAIN IN EXTREMITY (had a sore arm), RASH (she developed a rash on both of her legs) and SKIN LESION (Lesions on both legs, non -itchy.). At the time of the report, VASCULITIS (vasculitis), PAIN IN EXTREMITY (had a sore arm), RASH (she developed a rash on both of her legs) and SKIN LESION (Lesions on both legs, non -itchy.) outcome was unknown. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No treatment reported

Other Meds: SYNTHROID

Current Illness:

ID: 1570990
Sex: F
Age: 63
State:

Vax Date: 03/12/2021
Onset Date: 03/21/2021
Rec V Date: 08/15/2021
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Symptoms: injection site hard; feels pain/hurt; covid arm; injection site red; injection site itchy; nauseous; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE INDURATION (injection site hard), PAIN (feels pain/hurt), VACCINATION SITE REACTION (covid arm), VACCINATION SITE ERYTHEMA (injection site red) and VACCINATION SITE PRURITUS (injection site itchy) in a 63-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 048A21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. 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 21-Mar-2021, the patient experienced VACCINATION SITE INDURATION (injection site hard), PAIN (feels pain/hurt), VACCINATION SITE REACTION (covid arm), VACCINATION SITE ERYTHEMA (injection site red), VACCINATION SITE PRURITUS (injection site itchy) and NAUSEA (nauseous). The patient was treated with DIPHENHYDRAMINE HYDROCHLORIDE (BENADRYL ALLERGY [DIPHENHYDRAMINE HYDROCHLORIDE]) for Adverse event, at an unspecified dose and frequency. On 23-Mar-2021, VACCINATION SITE PRURITUS (injection site itchy) had resolved. At the time of the report, VACCINATION SITE INDURATION (injection site hard), PAIN (feels pain/hurt), VACCINATION SITE REACTION (covid arm), VACCINATION SITE ERYTHEMA (injection site red) and NAUSEA (nauseous) outcome was unknown. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Concomitant product use was not provided by the reporter. Reporter did not allow further contact

Other Meds:

Current Illness:

ID: 1570991
Sex: F
Age: 35
State:

Vax Date: 12/24/2020
Onset Date: 12/24/2020
Rec V Date: 08/15/2021
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Symptoms: Maternal exposure during pregnancy; This spontaneous prospective pregnancy case was reported by a consumer and describes the occurrence of MATERNAL EXPOSURE DURING PREGNANCY (Maternal exposure during pregnancy) in a 35-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 037KZ0A and 041L20A.) for COVID-19 vaccination. No Medical History information was reported. On 24-Dec-2020, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 21-Jan-2021, received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. Last menstrual period and estimated date of delivery were not provided. On 24-Dec-2020, the patient experienced MATERNAL EXPOSURE DURING PREGNANCY (Maternal exposure during pregnancy). On 21-Jan-2021, MATERNAL EXPOSURE DURING PREGNANCY (Maternal exposure during pregnancy) had resolved. No relevant concomitant medication was reported. Treatment information was not provided.

Other Meds:

Current Illness:

ID: 1570992
Sex: M
Age: 24
State: ID

Vax Date: 03/18/2021
Onset Date: 03/21/2021
Rec V Date: 08/15/2021
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Symptoms: fever; chills; headache; muscle aches; This spontaneous case was reported by a consumer and describes the occurrence of PYREXIA (fever), CHILLS (chills), HEADACHE (headache) and MYALGIA (muscle aches) in a 24-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 18-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 21-Mar-2021, the patient experienced PYREXIA (fever), CHILLS (chills), HEADACHE (headache) and MYALGIA (muscle aches). The patient was treated with IBUPROFEN for Fever and Headache, at an unspecified dose and frequency. At the time of the report, PYREXIA (fever) had resolved, CHILLS (chills) and MYALGIA (muscle aches) had not resolved and HEADACHE (headache) 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.

Other Meds:

Current Illness:

ID: 1570993
Sex: M
Age:
State: NY

Vax Date: 03/17/2021
Onset Date: 03/18/2021
Rec V Date: 08/15/2021
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Symptoms: fever last Thursday and Friday with a temperature of 100.5-.8 deg F.; This spontaneous case was reported by a consumer and describes the occurrence of PYREXIA (fever last Thursday and Friday with a temperature of 100.5-.8 deg F.) in an 85-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 17-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 18-Mar-2021, the patient experienced PYREXIA (fever last Thursday and Friday with a temperature of 100.5-.8 deg F.). At the time of the report, PYREXIA (fever last Thursday and Friday with a temperature of 100.5-.8 deg F.) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 18-Mar-2021, Body temperature: 100.5-8 (Inconclusive) temperature of 100.5-8 degrees F. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. concomitant medicines was not reported by reporter Treatment caller was not sure if his father took Tylenol For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments.

Other Meds:

Current Illness:

ID: 1570994
Sex: M
Age: 61
State: FL

Vax Date: 03/04/2021
Onset Date: 03/05/2021
Rec V Date: 08/15/2021
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Symptoms: swelling of lips; fever blisters; cracking of the upper lip; tremors in the kneecap, arms started shaking and shaking everywhere; was barely able to walk; This spontaneous case was reported by a consumer and describes the occurrence of TREMOR (tremors in the kneecap, arms started shaking and shaking everywhere), GAIT DISTURBANCE (was barely able to walk), LIP SWELLING (swelling of lips), ORAL HERPES (fever blisters) and CHAPPED LIPS (cracking of the upper lip) in a 61-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 025A21A) for COVID-19 vaccination. The patient's past medical history included Road traffic accident and Accident automobile. Concomitant products included GABAPENTIN, CARBAMAZEPINE and CLONAZEPAM for an unknown indication. On 04-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 05-Mar-2021, the patient experienced TREMOR (tremors in the kneecap, arms started shaking and shaking everywhere) and GAIT DISTURBANCE (was barely able to walk). On an unknown date, the patient experienced LIP SWELLING (swelling of lips), ORAL HERPES (fever blisters) and CHAPPED LIPS (cracking of the upper lip). The patient was treated with DIPHENHYDRAMINE HYDROCHLORIDE (BENADRYL [DIPHENHYDRAMINE HYDROCHLORIDE]) at an unspecified dose and frequency and LORAZEPAM at an unspecified dose and frequency. At the time of the report, TREMOR (tremors in the kneecap, arms started shaking and shaking everywhere), GAIT DISTURBANCE (was barely able to walk), LIP SWELLING (swelling of lips), ORAL HERPES (fever blisters) and CHAPPED LIPS (cracking of the upper lip) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. Treatment medications included Benadryl and Lorazepam.

Other Meds: GABAPENTIN; CARBAMAZEPINE; CLONAZEPAM

Current Illness:

ID: 1570995
Sex: F
Age: 37
State: TX

Vax Date: 02/23/2021
Onset Date:
Rec V Date: 08/15/2021
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Symptoms: I am pregnant and I was told I have to register in the pregnancy registry; This spontaneous prospective pregnancy case was reported by a consumer and describes the occurrence of EXPOSURE DURING PREGNANCY (I am pregnant and I was told I have to register in the pregnancy registry) in a 37-year-old female patient (gravida 7, para 2) who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 012A21A) for COVID-19 vaccination. Concurrent medical conditions included Hypothyroid issue. Concomitant products included LEVOTHYROXINE SODIUM (SYNTHROID), HYDROXYPROGESTERONE CAPROATE (MAKENA), ACETYLSALICYLIC ACID (BABY ASPIRIN), CALCIUM CARBONATE, COLECALCIFEROL (VITAMIN D 2000) and ELDERBERRY [SAMBUCUS NIGRA] for an unknown indication. On 23-Feb-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 10-Oct-2020 and the estimated date of delivery was 17-Jul-2021. On an unknown date, the patient experienced EXPOSURE DURING PREGNANCY (I am pregnant and I was told I have to register in the pregnancy registry). The patient received mRNA-1273 (Moderna COVID-19 Vaccine) beginning around the nineteenth week of the pregnancy. At the time of the report, EXPOSURE DURING PREGNANCY (I am pregnant and I was told I have to register in the pregnancy registry) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. On an unknown date, post vaccination, the patient reported that she experienced symtpoms of exposure during pregnancy. It was reported that, the patient had NIPT test and several ultrasounds on an unknown dates for which the result was unknown. No treatment information was provided

Other Meds: SYNTHROID; MAKENA; BABY ASPIRIN; VITAMIN D 2000; ELDERBERRY [SAMBUCUS NIGRA]

Current Illness:

ID: 1570996
Sex: F
Age:
State:

Vax Date: 02/05/2021
Onset Date: 03/05/2021
Rec V Date: 08/15/2021
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Symptoms: Half the dose on elbow; A spontaneous report was received from a consumer concerning herself, a 47-year-old female patient, who received Moderna's COVID-19 vaccine (mRNA-1273) and experienced half the dose ended up on elbow (underdose). The patient's medical history was not provided. Concomitant product use was not provided by the reporter. On 05 Feb 2021, the patient received her first of the two planned vaccine doses of mRNA-1273 (Lot number: 013M2CA), intramuscularly, in the left non dominant arm, for prophylaxis of COVID-19 infection. On 05 Mar 2021, the patient received her second of the two planned doses of mRNA-1273 (Lot number: 029A21A), via unknown route, in the left non dominant arm, for prophylaxis of COVID-19 infection. It was reported that the patient noticed during vaccine administration that half the dose ended up on elbow. Treatment information was not provided. The patient received both scheduled doses of mRNA-1273 prior to the event; therefore, action taken with the drug in response to the event was not applicable. The outcome of event was considered resolved on 05 Mar 2021.; Reporter's Comments: This report refers to a case of Underdose, for mRNA-1273, lot #: 029A21A, with no associated AEs.; Sender's Comments: US-MODERNATX, INC.-MOD-2021-054715:1st dose

Other Meds:

Current Illness:

ID: 1570997
Sex: F
Age: 58
State: SC

Vax Date: 03/17/2021
Onset Date: 03/17/2021
Rec V Date: 08/15/2021
Hospital:

Vax Type:
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Symptom List:

Symptoms: Acid Reflux; Diarrhea / Upset stomach; Nausea; Site of injection is hard and hurting her/Muscle part of patient's arm at injection site is sore; Fatigued; Deep pain in her stomach / Experiencing pain at the bottom of patient's stomach; Site of injection is hard; This spontaneous case was reported by a consumer and describes the occurrence of ABDOMINAL PAIN UPPER (Deep pain in her stomach / Experiencing pain at the bottom of patient's stomach), DIARRHOEA (Diarrhea / Upset stomach), GASTROOESOPHAGEAL REFLUX DISEASE (Acid Reflux), VACCINATION SITE INDURATION (Site of injection is hard) and FATIGUE (Fatigued) in a 58-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 027A21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 17-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 17-Mar-2021, the patient experienced ABDOMINAL PAIN UPPER (Deep pain in her stomach / Experiencing pain at the bottom of patient's stomach) and VACCINATION SITE INDURATION (Site of injection is hard). On 18-Mar-2021, the patient experienced FATIGUE (Fatigued). On 21-Mar-2021, the patient experienced VACCINATION SITE PAIN (Site of injection is hard and hurting her/Muscle part of patient's arm at injection site is sore). On 22-Mar-2021, the patient experienced DIARRHOEA (Diarrhea / Upset stomach) and NAUSEA (Nausea). On an unknown date, the patient experienced GASTROOESOPHAGEAL REFLUX DISEASE (Acid Reflux). The patient was treated with IBUPROFEN (MOTRIN [IBUPROFEN]) at an unspecified dose and frequency. At the time of the report, ABDOMINAL PAIN UPPER (Deep pain in her stomach / Experiencing pain at the bottom of patient's stomach), DIARRHOEA (Diarrhea / Upset stomach), GASTROOESOPHAGEAL REFLUX DISEASE (Acid Reflux), VACCINATION SITE INDURATION (Site of injection is hard), FATIGUE (Fatigued), VACCINATION SITE PAIN (Site of injection is hard and hurting her/Muscle part of patient's arm at injection site is sore) and NAUSEA (Nausea) had not resolved. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medications were reported. No treatment information was provided. This case was linked to MOD-2021-081598 (E2B Linked Report).; Sender's Comments: MOD-2021-081598:For second dose

Other Meds:

Current Illness:

ID: 1570998
Sex: F
Age:
State: VA

Vax Date: 03/18/2021
Onset Date: 03/01/2021
Rec V Date: 08/15/2021
Hospital:

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Symptom List:

Symptoms: Soreness in the left armpit lymph nodes; Extensive effort to lift arm; Can't even touch arm it is so sensitive; This spontaneous case was reported by a consumer and describes the occurrence of LYMPH NODE PAIN (Soreness in the left armpit lymph nodes), JOINT RANGE OF MOTION DECREASED (Extensive effort to lift arm) and SENSITISATION (Can't even touch arm it is so sensitive) in a 30-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 006B21A) for COVID-19 vaccination. No Medical History information was reported. On 18-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. In March 2021, the patient experienced LYMPH NODE PAIN (Soreness in the left armpit lymph nodes), JOINT RANGE OF MOTION DECREASED (Extensive effort to lift arm) and SENSITISATION (Can't even touch arm it is so sensitive). The patient was treated with IBUPROFEN ongoing since an unknown date at an unspecified dose and frequency and CANNABIDIOL at an unspecified dose and frequency. At the time of the report, LYMPH NODE PAIN (Soreness in the left armpit lymph nodes), JOINT RANGE OF MOTION DECREASED (Extensive effort to lift arm) and SENSITISATION (Can't even touch arm it is so sensitive) outcome was unknown. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Treatment details included ibuprofen and CBD.

Other Meds:

Current Illness:

ID: 1570999
Sex: M
Age: 47
State: NY

Vax Date: 03/20/2021
Onset Date: 03/20/2021
Rec V Date: 08/15/2021
Hospital:

Vax Type:
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Symptom List:

Symptoms: Lump in his arm pit; Pain in left arm near the shoulder; Sweatiness; Fever; This spontaneous case was reported by a consumer and describes the occurrence of AXILLARY MASS (Lump in his arm pit), PAIN IN EXTREMITY (Pain in left arm near the shoulder), HYPERHIDROSIS (Sweatiness) and PYREXIA (Fever) in a 47-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 20-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 20-Mar-2021, the patient experienced AXILLARY MASS (Lump in his arm pit), PAIN IN EXTREMITY (Pain in left arm near the shoulder), HYPERHIDROSIS (Sweatiness) and PYREXIA (Fever). On 21-Mar-2021, PAIN IN EXTREMITY (Pain in left arm near the shoulder), HYPERHIDROSIS (Sweatiness) and PYREXIA (Fever) had resolved. At the time of the report, AXILLARY MASS (Lump in his arm pit) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Concomitant product use was not provided by the reporter. No treatment information was provided.

Other Meds:

Current Illness:

ID: 1571000
Sex: M
Age:
State:

Vax Date: 03/06/2021
Onset Date: 03/11/2021
Rec V Date: 08/15/2021
Hospital:

Vax Type:
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Symptom List:

Symptoms: shortness of breath 5 days after receiving 1st dose; This spontaneous case was reported by a consumer and describes the occurrence of DYSPNOEA (shortness of breath 5 days after receiving 1st dose) in a 63-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 06-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) .5 ml. On 11-Mar-2021, the patient experienced DYSPNOEA (shortness of breath 5 days after receiving 1st dose). At the time of the report, DYSPNOEA (shortness of breath 5 days after receiving 1st dose) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Concomitant product use was not provided by the reporter. Treatment information was not provided. Reporter did not allow further contact

Other Meds:

Current Illness:

ID: 1571001
Sex: M
Age: 65
State: NJ

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

Vax Type:
Manufacturer:
Vax Name:
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Symptom List:

Symptoms: More pain in left arm than the first dose; Did not feel well; Felt a little feverish; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (More pain in left arm than the first dose), MALAISE (Did not feel well) and PYREXIA (Felt a little feverish) in a 65-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 039K20A and 026L20A) for COVID-19 vaccination. Concomitant products included METFORMIN and MULTIVITAMINS [VITAMINS NOS] 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 25-Feb-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 2 dosage form. On 25-Feb-2021, the patient experienced PAIN IN EXTREMITY (More pain in left arm than the first dose), MALAISE (Did not feel well) and PYREXIA (Felt a little feverish). At the time of the report, PAIN IN EXTREMITY (More pain in left arm than the first dose), MALAISE (Did not feel well) and PYREXIA (Felt a little feverish) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 15-Mar-2021, Anti-thyroid antibody: high (High) high. On 15-Mar-2021, Blood thyroid stimulating hormone: high (High) High. No treatment information was provided. The action taken with the drug was Not applicable. This case was linked to MOD-2021-054736 (Patient Link).

Other Meds: METFORMIN; MULTIVITAMINS [VITAMINS NOS]

Current Illness:

ID: 1571002
Sex: F
Age:
State: AL

Vax Date: 03/22/2021
Onset Date: 03/22/2021
Rec V Date: 08/15/2021
Hospital:

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

Allergies:

Symptom List:

Symptoms: headache; This spontaneous case was reported by a consumer and describes the occurrence of HEADACHE (headache) in a 62-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 002B21A) for COVID-19 vaccination. No Medical History information was reported. On 22-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 22-Mar-2021, the patient experienced HEADACHE (headache). At the time of the report, HEADACHE (headache) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medications included. Treatment information was not provided Most recent FOLLOW-UP information incorporated above includes: On 25-May-2021: Follow up received on 26-may-2021, patient updated that no side effects to the COVID-19 vaccine.

Other Meds:

Current Illness:

ID: 1571003
Sex: F
Age:
State: HI

Vax Date: 02/27/2021
Onset Date: 02/27/2021
Rec V Date: 08/15/2021
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Symptoms: Sore arm; Numbness; runny nose; deep heavy pressure in the chest; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (Sore arm), HYPOAESTHESIA (Numbness), RHINORRHOEA (runny nose) and CHEST DISCOMFORT (deep heavy pressure in the chest) 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 27-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 27-Feb-2021, the patient experienced PAIN IN EXTREMITY (Sore arm), HYPOAESTHESIA (Numbness), RHINORRHOEA (runny nose) and CHEST DISCOMFORT (deep heavy pressure in the chest). At the time of the report, PAIN IN EXTREMITY (Sore arm), HYPOAESTHESIA (Numbness), RHINORRHOEA (runny nose) and CHEST DISCOMFORT (deep heavy pressure in the chest) outcome was unknown. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Concomitant medications were not provided. No treatment medications provided. This case was linked to MOD-2021-061139 (Patient Link).

Other Meds:

Current Illness:

ID: 1571004
Sex: M
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 08/15/2021
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Symptoms: EYE LID SWELLING; This spontaneous case was reported by a consumer and describes the occurrence of SWELLING OF EYELID (EYE LID SWELLING) 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 SWELLING OF EYELID (EYE LID SWELLING). At the time of the report, SWELLING OF EYELID (EYE LID SWELLING) outcome was unknown. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Concomitant medication included eye drops. No treatment information was reported. The reporter stated that the patient experienced eye lid swelling after receiving the vaccine but the doctors said it was not because of eye drop medication. Then when the patient used the eye drop medication again, he experienced it again so the reporter stated that it was not because of Moderna vaccine.

Other Meds:

Current Illness:

ID: 1571005
Sex: F
Age: 86
State: GA

Vax Date: 02/24/2021
Onset Date:
Rec V Date: 08/15/2021
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Symptoms: Sinus allergy infection in her head; Runny nose; Sneezing; Sore throat; Headache; This spontaneous case was reported by a consumer and describes the occurrence of SINUSITIS (Sinus allergy infection in her head), RHINORRHOEA (Runny nose), SNEEZING (Sneezing), OROPHARYNGEAL PAIN (Sore throat) and HEADACHE (Headache) in an 86-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 050M20A) for COVID-19 vaccination. Concurrent medical conditions included Blood pressure high and Cardiac disorder. On 24-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 SINUSITIS (Sinus allergy infection in her head), RHINORRHOEA (Runny nose), SNEEZING (Sneezing), OROPHARYNGEAL PAIN (Sore throat) and HEADACHE (Headache). At the time of the report, SINUSITIS (Sinus allergy infection in her head) had not resolved and RHINORRHOEA (Runny nose), SNEEZING (Sneezing), OROPHARYNGEAL PAIN (Sore throat) and HEADACHE (Headache) outcome was unknown. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Concomitant products used included high blood pressure and cardiac medicines. Treatment medication included Coccidian for colds. The patient had experienced similar symptoms for years. She was due to get her second dose of vaccine on 24-Mar-2021.

Other Meds:

Current Illness: Blood pressure high; Cardiac disorder

ID: 1571006
Sex: F
Age: 88
State: CA

Vax Date: 01/29/2021
Onset Date: 03/21/2021
Rec V Date: 08/15/2021
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Symptoms: Chills; This spontaneous case was reported by a consumer and describes the occurrence of CHILLS (Chills) in an 88-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 001a21a and 001a21a) for COVID-19 vaccination. No medical history 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 21-Mar-2021, the patient experienced CHILLS (Chills). At the time of the report, CHILLS (Chills) outcome was unknown. Not Provided Other concomitant medications included unspecified thyroid medication. No treatment information was provided. The patient received both scheduled doses of mRNA-1273 prior to the events; therefore, action taken with the mRNA-1273 in response to the events was not applicable. Patient was doing fine. Most recent FOLLOW-UP information incorporated above includes: On 10-May-2021: TCR received. Clinical information updated.

Other Meds: AMLODIPINE BESYLATE; ALLOPURINOL; METOPROLOL SUCCINATE

Current Illness:

ID: 1571007
Sex: F
Age:
State: MA

Vax Date:
Onset Date:
Rec V Date: 08/15/2021
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Symptoms: Worse arm sore; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (Worse arm sore) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No medical history was provided by the reporter. 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 PAIN IN EXTREMITY (Worse arm sore). At the time of the report, PAIN IN EXTREMITY (Worse arm sore) outcome was unknown. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. This case was linked to US-MODERNATX, INC.-MOD-2021-054215 (Linked Report).; Sender's Comments: US-MODERNATX, INC.-MOD-2021-054215:Husband Case

Other Meds:

Current Illness:

ID: 1571008
Sex: F
Age: 71
State: MI

Vax Date: 02/09/2021
Onset Date: 03/01/2021
Rec V Date: 08/15/2021
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Symptoms: Heat In face; Swollen face; "Slits" for eyes; Rash on arms, face, neck and sides; Hives on arms, face, neck and sides; Missed second dose; This spontaneous case was reported by a consumer (subsequently medically confirmed) and describes the occurrence of PRODUCT DOSE OMISSION ISSUE (Missed second dose), URTICARIA (Hives on arms, face, neck and sides), FEELING HOT (Heat In face), SWELLING FACE (Swollen face) and EYE DISORDER ("Slits" for eyes) in a 71-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 015M20A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No medical reported history provided by the reporter. Concomitant products included GLIPIZIDE, METFORMIN, VERAPAMIL and SITAGLIPTIN PHOSPHATE (JANUVIA [SITAGLIPTIN PHOSPHATE]) 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 10-Mar-2021, the patient experienced URTICARIA (Hives on arms, face, neck and sides) and RASH (Rash on arms, face, neck and sides). In March 2021, the patient experienced PRODUCT DOSE OMISSION ISSUE (Missed second dose). On 17-Mar-2021, the patient experienced FEELING HOT (Heat In face), SWELLING FACE (Swollen face) and EYE DISORDER ("Slits" for eyes). In March 2021, PRODUCT DOSE OMISSION ISSUE (Missed second dose), URTICARIA (Hives on arms, face, neck and sides), FEELING HOT (Heat In face), SWELLING FACE (Swollen face), EYE DISORDER ("Slits" for eyes) and RASH (Rash on arms, face, neck and sides) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Treatment information included, oral prednisone and diphenhydramine was provided. Patients Chronic or long-standing health condition included diabetes but no recent change in status of chronic condition was reported. Most recent FOLLOW-UP information incorporated above includes: On 14-May-2021: Follow-up information received on 14-MAY 2021 contains Patient address updated, Patient demographic details and Anatomical location was updated

Other Meds: GLIPIZIDE; METFORMIN; VERAPAMIL; JANUVIA [SITAGLIPTIN PHOSPHATE]

Current Illness:

ID: 1571009
Sex: M
Age:
State: PA

Vax Date:
Onset Date:
Rec V Date: 08/15/2021
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Symptoms: 44 days after 1st dose and no 2nd dose yet; This spontaneous case was reported by an other health care professional and describes the occurrence of INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (44 days after 1st dose and no 2nd dose yet) 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 first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (44 days after 1st dose and no 2nd dose yet). At the time of the report, INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (44 days after 1st dose and no 2nd dose yet) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments.; Sender's Comments: This report refers to a case of Inappropriate Schedule Of Product Administration for mRNA-1273 (Lot number: Unknown) with no associated adverse events.

Other Meds:

Current Illness:

ID: 1571010
Sex: F
Age:
State: AZ

Vax Date: 03/19/2021
Onset Date: 03/21/2021
Rec V Date: 08/15/2021
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Symptoms: Red Arm; Hot Arm; This spontaneous case was reported by a consumer (subsequently medically confirmed) and describes the occurrence of VACCINATION SITE ERYTHEMA (Red Arm) and VACCINATION SITE WARMTH (Hot Arm) 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 19-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 21-Mar-2021, the patient experienced VACCINATION SITE ERYTHEMA (Red Arm) and VACCINATION SITE WARMTH (Hot Arm). At the time of the report, VACCINATION SITE ERYTHEMA (Red Arm) and VACCINATION SITE WARMTH (Hot Arm) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown.

Other Meds:

Current Illness:

ID: 1571011
Sex: F
Age: 74
State: CA

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

Symptoms: Dizziness; Weakness; Swelling of lips; Swelling of face; Swelling of tongue; Slurry speech; This spontaneous case was reported by a consumer and describes the occurrence of DIZZINESS (Dizziness), ASTHENIA (Weakness), LIP SWELLING (Swelling of lips), SWELLING FACE (Swelling of face) and SWOLLEN TONGUE (Swelling of tongue) in a 74-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 011M20A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. Concurrent medical conditions included Blood pressure high. On 23-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 23-Feb-2021, the patient experienced DIZZINESS (Dizziness), ASTHENIA (Weakness), LIP SWELLING (Swelling of lips), SWELLING FACE (Swelling of face), SWOLLEN TONGUE (Swelling of tongue) and DYSARTHRIA (Slurry speech). At the time of the report, DIZZINESS (Dizziness), ASTHENIA (Weakness), SWELLING FACE (Swelling of face), SWOLLEN TONGUE (Swelling of tongue) and DYSARTHRIA (Slurry speech) was resolving and LIP SWELLING (Swelling of lips) outcome was unknown. Not Provided DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 23-Feb-2021, Blood pressure measurement: high (High) High. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Concomitant medication included unspecified blood pressure medication. No treatment information was provided. Patient was kept for observation at vaccination center for 30 minutes and then to emergency room where patient was kept for observation for three hours.

Other Meds:

Current Illness: Blood pressure high

ID: 1571012
Sex: F
Age:
State: CA

Vax Date: 03/17/2021
Onset Date: 03/17/2021
Rec V Date: 08/15/2021
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Symptoms: Left arm was throbbing; Fever of 100 degrees F; Headache; Shooting pains in neck; This spontaneous case was reported by a consumer and describes the occurrence of NECK PAIN (Shooting pains in neck), VACCINATION SITE PAIN (Left arm was throbbing), PYREXIA (Fever of 100 degrees F) and HEADACHE (Headache) in a 65-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 0UIB21A) for COVID-19 vaccination. The patient's past medical history included COVID-19 on 28-Dec-2020. On 17-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 17-Mar-2021, the patient experienced NECK PAIN (Shooting pains in neck). On an unknown date, the patient experienced VACCINATION SITE PAIN (Left arm was throbbing), PYREXIA (Fever of 100 degrees F) and HEADACHE (Headache). The patient was treated with ACETYLSALICYLIC ACID, CAFFEINE, PARACETAMOL, SALICYLAMIDE (EXCEDRIN [ACETYLSALICYLIC ACID;CAFFEINE;PARACETAMOL;SALICYLAMIDE]) at an unspecified dose and frequency. At the time of the report, NECK PAIN (Shooting pains in neck), VACCINATION SITE PAIN (Left arm was throbbing), PYREXIA (Fever of 100 degrees F) and HEADACHE (Headache) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 28-Dec-2020, SARS-CoV-2 test: covid positive (Positive) Tested positive for COVID-19. On 17-Mar-2021, Body temperature: 100 (High) Fever of 100 degree F. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No relevant concomitant medications were reported.

Other Meds:

Current Illness:

ID: 1571013
Sex: F
Age: 68
State: GA

Vax Date: 03/16/2021
Onset Date: 03/22/2021
Rec V Date: 08/15/2021
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Symptom List:

Symptoms: Diarrhea; Chills; This spontaneous case was reported by a consumer and describes the occurrence of DIARRHOEA (Diarrhea) and CHILLS (Chills) in a 68-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 012M20A) for COVID-19 vaccination. No Medical History information was reported. On 16-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 22-Mar-2021, the patient experienced DIARRHOEA (Diarrhea) and CHILLS (Chills). At the time of the report, DIARRHOEA (Diarrhea) and CHILLS (Chills) had not resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant medication reported. No treatment was provided.

Other Meds:

Current Illness:

ID: 1571014
Sex: M
Age: 32
State: MI

Vax Date: 03/22/2021
Onset Date: 03/22/2021
Rec V Date: 08/15/2021
Hospital:

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Symptoms: a loss of taste; sore at the injection site; fatigued; drowsy; sluggish; This spontaneous case was reported by a consumer and describes the occurrence of SOMNOLENCE (drowsy), SLUGGISHNESS (sluggish), AGEUSIA (a loss of taste), VACCINATION SITE PAIN (sore at the injection site) and FATIGUE (fatigued) in a 31-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 038A21A) for COVID-19 vaccination. No Medical History information was reported. On 22-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 22-Mar-2021, the patient experienced SOMNOLENCE (drowsy), SLUGGISHNESS (sluggish), VACCINATION SITE PAIN (sore at the injection site) and FATIGUE (fatigued). On 23-Mar-2021, the patient experienced AGEUSIA (a loss of taste). At the time of the report, SOMNOLENCE (drowsy), SLUGGISHNESS (sluggish), AGEUSIA (a loss of taste), VACCINATION SITE PAIN (sore at the injection site) and FATIGUE (fatigued) outcome was unknown. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No relevant concomitant medications were provided. No treatment information was provided.

Other Meds:

Current Illness:

ID: 1571015
Sex: M
Age: 46
State: NY

Vax Date: 03/12/2021
Onset Date: 03/20/2021
Rec V Date: 08/15/2021
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Symptoms: Covid-19 positive after first dose; This spontaneous case was reported by a consumer and describes the occurrence of COVID-19 (Covid-19 positive after first dose) in a 46-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for an unknown indication. 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 20-Mar-2021, the patient experienced COVID-19 (Covid-19 positive after first dose). At the time of the report, COVID-19 (Covid-19 positive after first dose) outcome was unknown. Not Provided DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 20-Mar-2021, SARS-CoV-2 test: positive (Positive) COVID-19 positive. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant medication were reported No treatment medication were reported.

Other Meds:

Current Illness:

ID: 1571016
Sex: F
Age: 85
State: NY

Vax Date: 03/18/2021
Onset Date: 03/21/2021
Rec V Date: 08/15/2021
Hospital:

Vax Type:
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Allergies:

Symptom List:

Symptoms: Sneezing all day; Runny nose all day; This spontaneous case was reported by a consumer and describes the occurrence of SNEEZING (Sneezing all day) and RHINORRHOEA (Runny nose all day) in an 85-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 037A21B) for COVID-19 vaccination. No Medical History information was reported. On 18-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 21-Mar-2021, the patient experienced SNEEZING (Sneezing all day) and RHINORRHOEA (Runny nose all day). On 22-Mar-2021, SNEEZING (Sneezing all day) and RHINORRHOEA (Runny nose all day) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant medications were provided. No treatment information was provided. Reporter did not allow further contact Most recent FOLLOW-UP information incorporated above includes: On 06-Aug-2021: TCR received and contains No New Information.

Other Meds:

Current Illness:

ID: 1571017
Sex: F
Age: 69
State: NY

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

Vax Type:
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Allergies:

Symptom List:

Symptoms: Red face; Rash all over her body; This spontaneous case was reported by a consumer and describes the occurrence of ERYTHEMA (Red face) and RASH (Rash all over her body) in a 69-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 025A21A) for COVID-19 vaccination. 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 ERYTHEMA (Red face) and RASH (Rash all over her body). The patient was treated with CETIRIZINE HYDROCHLORIDE (ZYRTEC [CETIRIZINE HYDROCHLORIDE]) at a dose of 1 dosage form and DIPHENHYDRAMINE HYDROCHLORIDE (BENADRYL [DIPHENHYDRAMINE HYDROCHLORIDE]) at a dose of 1 dosage form. At the time of the report, ERYTHEMA (Red face) and RASH (Rash all over her body) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Concomitant medications were not reported. Most recent FOLLOW-UP information incorporated above includes: On 29-Jul-2021: Patient Demographics was added and Date of birth was added

Other Meds:

Current Illness:

ID: 1571018
Sex: M
Age:
State:

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

Vax Type:
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Lab Data:

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Symptom List:

Symptoms: Scheduled for 2nd dose on 06Mar2021 but he missed it; This spontaneous case was reported by a consumer and describes the occurrence of PRODUCT DOSE OMISSION ISSUE (Scheduled for 2nd dose on 06Mar2021 but he missed it) 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 06-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 PRODUCT DOSE OMISSION ISSUE (Scheduled for 2nd dose on 06Mar2021 but he missed it). At the time of the report, PRODUCT DOSE OMISSION ISSUE (Scheduled for 2nd dose on 06Mar2021 but he missed it) 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 information was not provided. Upon internal review on 24-May-2021, age was corrected to unknown.

Other Meds:

Current Illness:

ID: 1571019
Sex: F
Age: 41
State: WI

Vax Date: 03/23/2021
Onset Date: 03/23/2021
Rec V Date: 08/15/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
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Lab Data:

Allergies:

Symptom List:

Symptoms: eye is red; eye is burning; visual issues; vaccine squirted in her eye; This spontaneous case was reported by a nurse and describes the occurrence of OCULAR HYPERAEMIA (eye is red), EYE IRRITATION (eye is burning), VISUAL IMPAIRMENT (visual issues) and ACCIDENTAL EXPOSURE TO PRODUCT (vaccine squirted in her eye) in a 41-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 003A21A) for COVID-19 vaccination. No Medical History information was reported. On 23-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 23-Mar-2021, the patient experienced OCULAR HYPERAEMIA (eye is red), EYE IRRITATION (eye is burning), VISUAL IMPAIRMENT (visual issues) and ACCIDENTAL EXPOSURE TO PRODUCT (vaccine squirted in her eye). On 23-Mar-2021, ACCIDENTAL EXPOSURE TO PRODUCT (vaccine squirted in her eye) had resolved. At the time of the report, OCULAR HYPERAEMIA (eye is red), EYE IRRITATION (eye is burning) and VISUAL IMPAIRMENT (visual issues) had not resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No concomitant drugs were reported. No treatment medications were reported.

Other Meds:

Current Illness:

ID: 1571020
Sex: F
Age: 73
State: IN

Vax Date: 03/22/2021
Onset Date: 03/22/2021
Rec V Date: 08/15/2021
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Symptoms: Sore arm; Chills; Fever; Body ache; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (Sore arm), CHILLS (Chills), PYREXIA (Fever) and MYALGIA (Body ache) in a 73-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 006821A) for COVID-19 vaccination. No Medical History information was reported. On 22-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 22-Mar-2021, the patient experienced PAIN IN EXTREMITY (Sore arm), CHILLS (Chills), PYREXIA (Fever) and MYALGIA (Body ache). At the time of the report, PAIN IN EXTREMITY (Sore arm), CHILLS (Chills), PYREXIA (Fever) and MYALGIA (Body ache) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown.

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Current Illness:

ID: 1571021
Sex: F
Age: 54
State: TX

Vax Date: 03/12/2021
Onset Date: 03/16/2021
Rec V Date: 08/15/2021
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Symptoms: Vertigo; This spontaneous case was reported by a health care professional and describes the occurrence of VERTIGO (Vertigo) in a 54-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) (Intramuscular) 1 dosage form. On 16-Mar-2021, the patient experienced VERTIGO (Vertigo). The patient was treated with DIPHENHYDRAMINE HYDROCHLORIDE (BENADRYL [DIPHENHYDRAMINE HYDROCHLORIDE]) for Adverse event, at an unspecified dose and frequency and AMOXICILLIN for Adverse event, at an unspecified dose and frequency. At the time of the report, VERTIGO (Vertigo) 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. No concomitant medication was reported.

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Current Illness:

ID: 1571022
Sex: F
Age: 58
State: TX

Vax Date: 03/17/2021
Onset Date: 03/17/2021
Rec V Date: 08/15/2021
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Symptoms: Worried; (Ball) hurts; Has a little ball, and a little higher there is another ball in her neck in the left side/Inflammed nodes; Itchy in the injection zone; Little bumps in the injection zone; Pain in the injection zone; This spontaneous case was reported by a consumer and describes the occurrence of ANXIETY (Worried), PAIN ((Ball) hurts), VACCINATION SITE MASS (Little bumps in the injection zone), LYMPHADENOPATHY (Has a little ball, and a little higher there is another ball in her neck in the left side/Inflammed nodes) and VACCINATION SITE PRURITUS (Itchy in the injection zone) in a 58-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 VITAMIN B12 [VITAMIN B12 NOS], MULTIVITAMINS [VITAMINS NOS], COLECALCIFEROL (D3 VITAMIN) and BIOTIN for an unknown indication. On 17-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 17-Mar-2021, the patient experienced VACCINATION SITE PAIN (Pain in the injection zone). On 22-Mar-2021, the patient experienced VACCINATION SITE MASS (Little bumps in the injection zone) and VACCINATION SITE PRURITUS (Itchy in the injection zone). On 23-Mar-2021, the patient experienced ANXIETY (Worried), PAIN ((Ball) hurts) and LYMPHADENOPATHY (Has a little ball, and a little higher there is another ball in her neck in the left side/Inflammed nodes). At the time of the report, ANXIETY (Worried), PAIN ((Ball) hurts), VACCINATION SITE MASS (Little bumps in the injection zone), LYMPHADENOPATHY (Has a little ball, and a little higher there is another ball in her neck in the left side/Inflammed nodes), VACCINATION SITE PRURITUS (Itchy in the injection zone) and VACCINATION SITE PAIN (Pain in the injection zone) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No treatment medication details was reported.

Other Meds: VITAMIN B12 [VITAMIN B12 NOS]; MULTIVITAMINS [VITAMINS NOS]; D3 VITAMIN; BIOTIN

Current Illness:

Total 2021 VAERS Injuries: 599,999

Page last modified: 03 October 2021 5:28pm