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: 1580944
Sex: F
Age: 78
State: IN

Vax Date: 01/27/2021
Onset Date: 02/27/2021
Rec V Date: 08/18/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Dysphagia, Epiglottitis

Symptoms: Shaking more than usual; A spontaneous report was received from a consumer concerning a 78-year-old, female patient who received Moderna's COVID-19 Vaccine (mRNA-1273) and developed Tremor. The patient's medical history included Parkinson's disease.. Products known to have been used by the patient, within two weeks prior to the event, not reported. On 27 Feb 2021, prior to the onset of the event, the patient received their second of two planned doses of mRNA-1273 (Lot 007ML0A) intramuscularly in the right arm for prophylaxis of COVID-19 infection. On 27 Feb 2021, the patient developed Tremor. Treatment for the event, was not reported. Action taken with mRNA-1273 in response to the event was not reported. The outcome of the event, tremor was considered unknown.

Other Meds:

Current Illness:

ID: 1580945
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 08/18/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Anxiety, Dyspnoea

Symptoms: sore arm for the 1st vaccine; 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 PAIN IN EXTREMITY (sore arm for the 1st vaccine) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The patient's past medical history included No adverse event. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced PAIN IN EXTREMITY (sore arm for the 1st vaccine). At the time of the report, PAIN IN EXTREMITY (sore arm for the 1st vaccine) had not resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No treatment and concomitant medications were provided by reporter. Reporter did not allow further contact

Other Meds:

Current Illness:

ID: 1580946
Sex: M
Age:
State: NY

Vax Date: 01/19/2021
Onset Date:
Rec V Date: 08/18/2021
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: felt sleepy; soreness; pain at the injection site; This spontaneous case was reported by a consumer and describes the occurrence of SOMNOLENCE (felt sleepy), PAIN (soreness) and VACCINATION SITE PAIN (pain at the injection site) in a 72-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The patient's past medical history included No adverse event. On 19-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 SOMNOLENCE (felt sleepy), PAIN (soreness) and VACCINATION SITE PAIN (pain at the injection site). At the time of the report, SOMNOLENCE (felt sleepy), PAIN (soreness) and VACCINATION SITE PAIN (pain at the injection site) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Treatment medications included Tylenol. No concomitant medications were provided by reporter.

Other Meds:

Current Illness:

ID: 1580947
Sex: F
Age: 81
State:

Vax Date: 02/16/2021
Onset Date:
Rec V Date: 08/18/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Injection site pain; Injection site swelling; A spontaneous report was received from a consumer concerning about a 81 years old female patient, who received Moderna's COVID-19 vaccine (mRNA-1273) and experienced events injection site pain and injection site swelling. The patient's medical history was not reported. Concomitant medications were reported as acetylsalicylic acid, metoprolol, isosorbide, losartan and fenofibrate. On 16 Feb 2021, prior to the onset of the events the patient received their second planned doses of mRNA-1273 (Batch number: unknown) via intramuscular in right upper arm for the prophylaxis of COVID-19 infection. Later the patient experienced events injection site pain and injection site swelling. Laboratory details was not mentioned. Treatment information was not provided. Action taken with mRNA-1273 in response to the event are unknown. The outcomes of the events injection site pain and injection site swelling remain unknown.

Other Meds: BABY ASPIRIN; METOPROLOL; ISOSORBIDE; LOSARTAN; FENOFIBRATE

Current Illness:

ID: 1580948
Sex: M
Age: 81
State: FL

Vax Date: 02/12/2021
Onset Date: 02/12/2021
Rec V Date: 08/18/2021
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: Shoulder is still sore; A spontaneous report was received from a consumer concerning a 80-years-old male patient who received Moderna's COVID-19 vaccine (mRNA-1273) and patient's shoulder was sore/ arthralgia. The patient's medical history was not provided. Concomitant product use was not provided by the reporter. On 12 Feb 2021, prior to the onset of the event, the patient received their first of two planned doses of mRNA-1273 (batch: 039K20A) intramuscularly for prophylaxis of COVID-19 infection. On 12 Feb 2021, the patient's shoulder was sore. No treatment information was provided. Action taken with mRNA-1273 in response to the event was not provided. The outcome of event, shoulder was sore was unknown.

Other Meds:

Current Illness:

ID: 1580949
Sex: M
Age:
State: PA

Vax Date:
Onset Date:
Rec V Date: 08/18/2021
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: Fever; Chills; Body aches; Headache; Fatigue; A spontaneous report was received from a reporter(consumer) concerning unknown age, male patient , who received Moderna's COVID-19 vaccine (mRNA-1273) and experienced fever,chills, body aches, headache, fatigue and temperature was about 103 degree fahrenheit. The patient medical history was not provided. The relevant concomitant medications were also not provided. On unknown date , prior to the consent of the events, the patients received their second of two planned doses of mRNA-1273(batch number: not provided) through the unknown route of administration for prophylaxis of COVID-19 injection. On unknown date the patient experienced pyrexia, chills, myalgia, headache, fatigue and temperature was about 103 degree Fahrenheit. Patient was feeling better Laboratory details not provided. No treatment information was provided. Action taken with mRNA-1273 in response to the events was not reported. The outcome of the events were unknown.

Other Meds:

Current Illness:

ID: 1580950
Sex: F
Age: 36
State: MA

Vax Date: 01/28/2021
Onset Date: 01/28/2021
Rec V Date: 08/18/2021
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: left arm pain; slight headache; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (left arm pain) and HEADACHE (slight headache) in a 36-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. o28l20a) for COVID-19 vaccination. No Medical History information was reported. On 28-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 28-Jan-2021, the patient experienced PAIN IN EXTREMITY (left arm pain) and HEADACHE (slight headache). At the time of the report, PAIN IN EXTREMITY (left arm pain) and HEADACHE (slight headache) had not resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medications and treatment medications were reported. Reporter did not allow further contact

Other Meds:

Current Illness:

ID: 1580951
Sex: F
Age: 70
State:

Vax Date: 02/11/2021
Onset Date: 02/18/2021
Rec V Date: 08/18/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Pharyngeal swelling

Symptoms: Itching on arm; Transient pain on arm; A spontaneous report was received from a Consumer concerning a 70 years old female patient who received Moderna's COVID-19 vaccine (mRNA-1273) and experienced Itching on arm (Pruritus), Transient pain on arm (Pain in extremity). The patient's medical history was not provided. Relevant concomitant medication was reported ELIQUIS. On 11 FEB 2021, prior to the onset of the events the patient received their planned dose of mRNA-1273 (lot/batch: 031M20A) intramuscularly in the left arm for prophylaxis of COVID-19 infection. On 18 FEB 2021, the patient experienced Itching on arm (Pruritus), Transient pain on arm (Pain in extremity). Laboratory details were not provided. Treatment information was provided as antibiotic. Action taken with mRNA-1273 in response to the events was not reported. At the of this report, the outcome of the event's Itching on arm (Pruritus), Transient pain on arm (Pain in extremity) was considered as unknown.

Other Meds: ELIQUIS

Current Illness:

ID: 1580952
Sex: F
Age: 77
State: GA

Vax Date: 02/11/2021
Onset Date: 02/11/2021
Rec V Date: 08/18/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Eyes Swollen almost shut; weak; dead arm; Itchy rash all over the body; chills; soreness in arm; tingling in arm; This spontaneous case was reported by a consumer and describes the occurrence of RASH PRURITIC (Itchy rash all over the body), EYE SWELLING (Eyes Swollen almost shut), AMBLYOPIA (weak), CHILLS (chills) and LIMB DISCOMFORT (soreness in arm) in a 77-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. The patient's past medical history included No adverse event. On 11-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 11-Feb-2021, the patient experienced CHILLS (chills), LIMB DISCOMFORT (soreness in arm) and PARAESTHESIA (tingling in arm). On 19-Feb-2021, the patient experienced RASH PRURITIC (Itchy rash all over the body). On an unknown date, the patient experienced EYE SWELLING (Eyes Swollen almost shut), AMBLYOPIA (weak) and HYPOAESTHESIA (dead arm). At the time of the report, RASH PRURITIC (Itchy rash all over the body), AMBLYOPIA (weak), CHILLS (chills), LIMB DISCOMFORT (soreness in arm) and HYPOAESTHESIA (dead arm) outcome was unknown. Treatment and concomitant medications were not provided by reporter. Most recent FOLLOW-UP information incorporated above includes: On 22-Feb-2021: Adverse events were updated.

Other Meds:

Current Illness:

ID: 1580953
Sex: F
Age: 68
State: FL

Vax Date: 02/03/2021
Onset Date: 02/15/2021
Rec V Date: 08/18/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Diarrhoea, Nasal congestion

Symptoms: A spontaneous report was received from a consumer concerning a 68-years-old female patient who received Moderna's COVID-19 vaccine (mRNA-1273) and experienced events headache, ringing in ears/tinnitus, dull discomfort upon movement/discomfort, lethargy. The patient's medical history was not provided. No relevant concomitant medications were reported. On 3 Feb 2021, prior to the onset of the events the patient received first of two planned doses of mRNA-1273 (lot/batch: 038K20A) intramuscularly for prophylaxis of COVID-19 infection. On an unknown date, the patient experienced the event(s) headache, ringing in ears, dull discomfort upon movement, lethargy. No treatment information was provided. Action taken with mRNA-1273 in response to the events was not reported. The outcome of event(s), headache, ringing in ears, dull discomfort upon movement, lethargy was unknown.

Other Meds: OMEGA 3 FISH OILS

Current Illness:

ID: 1580954
Sex: F
Age:
State: FL

Vax Date: 12/23/2020
Onset Date:
Rec V Date: 08/18/2021
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: pain in the arm; Back pain; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (pain in the arm) and BACK PAIN (Back pain) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 028L20A. and 025K20A) for COVID-19 vaccination. The patient's past medical history included No adverse event. On 23-Dec-2020, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 21-Jan-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On an unknown date, the patient experienced PAIN IN EXTREMITY (pain in the arm) and BACK PAIN (Back pain). The patient was treated with IBUPROFEN (ADVIL 12 HOUR) at an unspecified dose and frequency. At the time of the report, PAIN IN EXTREMITY (pain in the arm) and BACK PAIN (Back pain) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) and mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown Route) was unknown. No concomitant medications were provided by reporter.

Other Meds:

Current Illness:

ID: 1580955
Sex: M
Age: 61
State: KS

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

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

Lab Data:

Allergies:

Symptom List: Rash, Urticaria

Symptoms: Very sick; high blood sugar; This spontaneous case was reported by a pharmacist and describes the occurrence of ILLNESS (Very sick) and BLOOD GLUCOSE INCREASED (high blood sugar) in a 61-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The patient's past medical history included COVID-19 virus test positive. Concurrent medical conditions included Diabetes mellitus (type 1 diabetes). Concomitant products included MONOCLONAL ANTIBODY 17-1A for COVID-19, INSULIN for an unknown indication. On 29-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 ILLNESS (Very sick) and BLOOD GLUCOSE INCREASED (high blood sugar). At the time of the report, ILLNESS (Very sick) and BLOOD GLUCOSE INCREASED (high blood sugar) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. The treatment medication was not provided.

Other Meds: MONOCLONAL ANTIBODY 17-1A; INSULIN

Current Illness:

ID: 1580956
Sex: F
Age: 40
State: MN

Vax Date: 02/10/2021
Onset Date: 02/10/2021
Rec V Date: 08/18/2021
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: This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (regular arm pain/arm felt super achy/felt like she was punched in the arm), RASH MACULAR (Rash on both arms/8 spots on left arm/16 spots on right arm), RASH PRURITIC (noticed red bumps that were itchy on right forearm), SKIN LESION INFLAMMATION (Rash inflamed) and SKIN BURNING SENSATION (skin felt like it was on fire/"it felt hot") in a 40-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 010M20A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. Concurrent medical conditions included Dust allergy and House dust mite allergy. Concomitant products included FLUOXETINE HYDROCHLORIDE (PROZAC) for an unknown indication. On 10-Feb-2021 at 3:30 PM, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 10-Feb-2021, the patient experienced PAIN IN EXTREMITY (regular arm pain/arm felt super achy/felt like she was punched in the arm). On 12-Feb-2021, the patient experienced AXILLARY PAIN (pain on left armpit), NAUSEA (nausea) and PYREXIA (fever of 101.6F). On 18-Feb-2021, the patient experienced RASH PRURITIC (noticed red bumps that were itchy on right forearm) and SKIN LESION INFLAMMATION (Rash inflamed). On 19-Feb-2021, the patient experienced RASH MACULAR (Rash on both arms/8 spots on left arm/16 spots on right arm). On 21-Feb-2021, the patient experienced SKIN BURNING SENSATION (skin felt like it was on fire/"it felt hot") and SKIN REACTION (skin around the bumps looked angry). The patient was treated with Bed rest for Pyrexia. On 17-Feb-2021, AXILLARY PAIN (pain on left armpit) had resolved. At the time of the report, PAIN IN EXTREMITY (regular arm pain/arm felt super achy/felt like she was punched in the arm), RASH MACULAR (Rash on both arms/8 spots on left arm/16 spots on right arm), RASH PRURITIC (noticed red bumps that were itchy on right forearm), SKIN LESION INFLAMMATION (Rash inflamed), SKIN BURNING SENSATION (skin felt like it was on fire/"it felt hot"), SKIN REACTION (skin around the bumps looked angry), NAUSEA (nausea) and PYREXIA (fever of 101.6F) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Additional concomitant medication use included birth control (type not specified) Treatment medications included ibuprofen, Benadryl and hydrocortisone cream. The consumer gave consent for Safety follow up. Most recent FOLLOW-UP information incorporated above includes: On 28-Apr-2021: Contact Info updated

Other Meds: PROZAC

Current Illness: Dust allergy; House dust mite allergy

ID: 1580957
Sex: F
Age: 60
State: CA

Vax Date: 01/22/2021
Onset Date: 01/29/2021
Rec V Date: 08/18/2021
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: rash on her whole upper arm; This spontaneous case was reported by a health care professional (subsequently medically confirmed) and describes the occurrence of RASH (rash on her whole upper arm) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 027L20A) for an unknown indication. The patient's past medical history included No adverse event. On 22-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 29-Jan-2021, the patient experienced RASH (rash on her whole upper arm). At the time of the report, RASH (rash on her whole upper 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. no concomitant medications are provided by the reporter. treatment to the events are not provided.

Other Meds:

Current Illness:

ID: 1580958
Sex: F
Age: 65
State: NY

Vax Date: 02/19/2021
Onset Date:
Rec V Date: 08/18/2021
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: Fever; Tingling all along fingers and hands; Body aches; Arm sore; This spontaneous case was reported by a nurse (subsequently medically confirmed) and describes the occurrence of PYREXIA (Fever), PARAESTHESIA (Tingling all along fingers and hands), MYALGIA (Body aches) and PAIN IN EXTREMITY (Arm sore) in a 65-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 012M20A) for COVID-19 vaccination. The patient's past medical history included No adverse event (No medical history reported.). On 19-Feb-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On an unknown date, the patient experienced PYREXIA (Fever), PARAESTHESIA (Tingling all along fingers and hands), MYALGIA (Body aches) and PAIN IN EXTREMITY (Arm sore). At the time of the report, PYREXIA (Fever), PARAESTHESIA (Tingling all along fingers and hands), MYALGIA (Body aches) and PAIN IN EXTREMITY (Arm sore) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. Treatment and concomitant medications were not provided by reporter.

Other Meds:

Current Illness:

ID: 1580959
Sex: M
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 08/18/2021
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: Side effects after vaccination; This spontaneous case was reported by an other caregiver and describes the occurrence of VACCINATION COMPLICATION (Side effects after vaccination) 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) (Intramuscular) 1 dosage form. On an unknown date, the patient experienced VACCINATION COMPLICATION (Side effects after vaccination). At the time of the report, VACCINATION COMPLICATION (Side effects after vaccination) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medications and treatment details were provided.

Other Meds:

Current Illness:

ID: 1580960
Sex: F
Age: 75
State: CA

Vax Date: 02/09/2021
Onset Date: 02/10/2021
Rec V Date: 08/18/2021
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: Area where she had the injection was red; Tender rash; A lump; It was Itchy; It was hard; Arm hurt; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE PAIN (Arm hurt), VACCINATION SITE ERYTHEMA (Area where she had the injection was red), INJECTION SITE RASH (Tender rash), VACCINATION SITE SWELLING (A lump) and VACCINATION SITE PRURITUS (It was Itchy) 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 information was reported. On 09-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 10-Feb-2021, the patient experienced VACCINATION SITE PAIN (Arm hurt). On 20-Feb-2021, the patient experienced VACCINATION SITE ERYTHEMA (Area where she had the injection was red), INJECTION SITE RASH (Tender rash), VACCINATION SITE SWELLING (A lump), VACCINATION SITE PRURITUS (It was Itchy) and VACCINATION SITE INDURATION (It was hard). On 10-Feb-2021, VACCINATION SITE PAIN (Arm hurt) had resolved. At the time of the report, VACCINATION SITE ERYTHEMA (Area where she had the injection was red), VACCINATION SITE SWELLING (A lump), VACCINATION SITE PRURITUS (It was Itchy) and VACCINATION SITE INDURATION (It was hard) 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 and concomitant medications were not provided by reporter.

Other Meds:

Current Illness:

ID: 1580961
Sex: F
Age: 77
State: FL

Vax Date: 01/23/2021
Onset Date: 01/23/2021
Rec V Date: 08/18/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Blister; Rash; This spontaneous case was reported by a health care professional and describes the occurrence of BLISTER (Blister) and RASH (Rash) in a 77-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The patient's past medical history included No adverse event (no historical condition reported.). On 23-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 23-Jan-2021, the patient experienced BLISTER (Blister) and RASH (Rash). At the time of the report, BLISTER (Blister) and RASH (Rash) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown Route) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown Route), the reporter did not provide any causality assessments. No concomitant medication were reported. Treatment medication included antibiotic ointment. Reporter did not allow further contact

Other Meds:

Current Illness:

ID: 1580962
Sex: M
Age: 76
State: FL

Vax Date: 01/26/2021
Onset Date:
Rec V Date: 08/18/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Tenderness in the injection site; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE PAIN (Tenderness in the injection site) in a 76-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 030L20A) for COVID-19 vaccination. No Medical History information was reported. On 26-Jan-2021, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced VACCINATION SITE PAIN (Tenderness in the injection site). At the time of the report, VACCINATION SITE PAIN (Tenderness in the injection site) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Treatment and concomitant medications were not provided by reporter.

Other Meds:

Current Illness:

ID: 1580963
Sex: F
Age:
State: TX

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

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

Lab Data:

Allergies:

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

Symptoms: Pregnant patient received the moderna vaccine; This spontaneous prospective pregnancy case was reported by a health care professional and describes the occurrence of MATERNAL EXPOSURE DURING PREGNANCY (Pregnant patient received the moderna vaccine) in a female patient of an unknown age (gravida 1) who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 012M20A) for COVID-19 vaccination. No Medical History information was reported. On 02-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. The patient's last menstrual period was on 19-May-2020 and the estimated date of delivery was 23-Feb-2021. On 02-Feb-2021, the patient experienced MATERNAL EXPOSURE DURING PREGNANCY (Pregnant patient received the moderna vaccine). The patient received mRNA-1273 (Moderna COVID-19 Vaccine) beginning around the thirty-seventh week of the pregnancy. The vaginal delivery occurred on 03-Mar-2021, which was reported as Full-term. For neonate 1, the birth weight was 4170 grams (9lbs 3oz) with an APGAR score of 8 and 10 at (1, 5 minutes). The outcome was reported as Term Birth NOS. Baby's head was stuck and doctor had to use vacuum to help deliver him. Perinatal complications include JAUNDICE.. Male baby(Infant) length is 54.6cm, Head circumference is 45.7cm. On 02-Feb-2021, MATERNAL EXPOSURE DURING PREGNANCY (Pregnant patient received the moderna vaccine) had resolved. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 16-Jun-2020, Pregnancy test: positive (Positive) positive. On 20-Jul-2020, Blood test: normal (normal) normal. On 20-Jul-2020, Ultrasound scan: pregnant (Inconclusive) Pregnant. On 03-Dec-2020, Glucose tolerance test: 164 (High) 164. On 09-Dec-2020, Glucose tolerance test: 159,141, 165, 83 (Inconclusive) 159,141,165,83.. On 02-Mar-2021, Ultrasound scan: meconium in amniotic sac (Inconclusive) Meconium in amniotic sac.. 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. Medical history of the patient included-Maternal Grandma (Arthritis), Paternal Grandma (Arthritis, Glaucoma), Paternal Grandpa (Stroke). This case was linked to MOD-2021-080805 (Parent-Child Link). See case MOD-2021-080805 for details regarding the child case.

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

Current Illness:

ID: 1580964
Sex: M
Age:
State: MD

Vax Date:
Onset Date:
Rec V Date: 08/18/2021
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, Lymph node pain, Lymphadenopathy

Symptoms: This spontaneous case reported by a consumer, describes the occurrence of somnolence (sleepy) in a 65-year-old male patient who received mRNA-1273 (Moderna COVID-19 vaccine) for COVID-19 immunization. No medical history provided. On an unknown date, patient received a dose of mRNA-1273 (Moderna COVID-19 vaccine), unknown route; 1 dosage form. On an unknown date, patient experienced somnolence (sleepy). At the time of the report, somnolence (sleepy): resolved. The action taken with mRNA-1273 (Moderna COVID-19 vaccine): unknown. This case linked to MOD-2021-020448; MOD-2021-020371 (E2B linked report). Sender's comments: MOD-2021-020448: Same reporter, reporter herself. MOD-2021-020371: Same reporter, reporter's sister.

Other Meds:

Current Illness:

ID: 1580965
Sex: F
Age: 80
State: IN

Vax Date: 01/20/2021
Onset Date: 01/22/2021
Rec V Date: 08/18/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Unevaluable event

Symptoms: high blood pressure; headache; red rash on arm above elbow; This spontaneous case was reported by a consumer and describes the occurrence of HYPERTENSION (high blood pressure), RASH ERYTHEMATOUS (red rash on arm above elbow) and HEADACHE (headache) in an 80-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No medical history was provided by the reporter. Concurrent medical conditions included Hypertension and Cholesterol. Concomitant products included COLECALCIFEROL (VITAMIN D 3) and POTASSIUM for an unknown indication. On 20-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 22-Jan-2021, the patient experienced RASH ERYTHEMATOUS (red rash on arm above elbow). On an unknown date, the patient experienced HYPERTENSION (high blood pressure) and HEADACHE (headache). At the time of the report, HYPERTENSION (high blood pressure), RASH ERYTHEMATOUS (red rash on arm above elbow) and HEADACHE (headache) outcome was unknown. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown Route) was unknown. This case was linked to MOD-2021-020519 (Patient Link). Most recent FOLLOW-UP information incorporated above includes: On 22-Feb-2021: No specific follow-up information recorded.

Other Meds: VITAMIN D 3; POTASSIUM

Current Illness: Hypertension

ID: 1580966
Sex: F
Age:
State: NJ

Vax Date: 01/27/2021
Onset Date: 02/17/2021
Rec V Date: 08/18/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: cold; This spontaneous case was reported by a consumer and describes the occurrence of NASOPHARYNGITIS (cold) in a 68-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No medical history was provided by the reporter. On 27-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 17-Feb-2021, the patient experienced NASOPHARYNGITIS (cold). At the time of the report, NASOPHARYNGITIS (cold) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown Route) was unknown.

Other Meds:

Current Illness:

ID: 1580967
Sex: M
Age: 75
State: WI

Vax Date: 01/22/2021
Onset Date: 01/22/2021
Rec V Date: 08/18/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Injection site pain, Pain

Symptoms: sleepiness; fatigue; This spontaneous case was reported by a health care professional and describes the occurrence of SOMNOLENCE (sleepiness) and FATIGUE (fatigue) in a 75-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 LEVETIRACETAM (KEPPRA), ATORVASTATIN, METOPROLOL, DOFETILIDE (TIKOSYN), RIVAROXABAN (XARELTO) and OMEPRAZOLE for an unknown indication. On 22-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 22-Jan-2021, the patient experienced SOMNOLENCE (sleepiness) and FATIGUE (fatigue). The patient was treated with PARACETAMOL (TYLENOL) at an unspecified dose and frequency. On 22-Jan-2021, SOMNOLENCE (sleepiness) and FATIGUE (fatigue) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. This case was linked (E2B Linked Report).; Sender's Comments: Same patient, 2nd dose

Other Meds: KEPPRA; ATORVASTATIN; METOPROLOL; TIKOSYN; XARELTO; OMEPRAZOLE.

Current Illness:

ID: 1580968
Sex: F
Age:
State: NJ

Vax Date: 02/20/2021
Onset Date: 02/20/2021
Rec V Date: 08/18/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Injection site pain, Menorrhagia

Symptoms: Arm is so sore; Arm is red/ Red skin; Arm with a little tenderness; This spontaneous case was reported by a consumer and describes the occurrence of ERYTHEMA (Arm is red/ Red skin), TENDERNESS (Arm with a little tenderness) and PAIN IN EXTREMITY (Arm is so 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 20-Feb-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 20-Feb-2021, the patient experienced ERYTHEMA (Arm is red/ Red skin) and TENDERNESS (Arm with a little tenderness). On an unknown date, the patient experienced PAIN IN EXTREMITY (Arm is so sore). At the time of the report, ERYTHEMA (Arm is red/ Red skin), TENDERNESS (Arm with a little tenderness) and PAIN IN EXTREMITY (Arm is so sore) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown.

Other Meds:

Current Illness:

ID: 1580969
Sex: F
Age: 54
State: TN

Vax Date: 01/04/2021
Onset Date: 01/05/2021
Rec V Date: 08/18/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: tenderness; pain at injection site; This spontaneous case was reported by a health care professional and describes the occurrence of INJECTION SITE PAIN (pain at injection site) and TENDERNESS (tenderness) in a 54-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 025L20A) for COVID-19 vaccination. No medical history was provided by the reporter. On 04-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 05-Jan-2021, the patient experienced INJECTION SITE PAIN (pain at injection site). On 18-Jan-2021, the patient experienced TENDERNESS (tenderness). On 12-Jan-2021, INJECTION SITE PAIN (pain at injection site) had resolved. At the time of the report, TENDERNESS (tenderness) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments.

Other Meds:

Current Illness:

ID: 1580970
Sex: F
Age: 55
State: TX

Vax Date: 01/27/2021
Onset Date: 01/27/2021
Rec V Date: 08/18/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Can barely move her arm; Diarrhea; Body aches; Very swollen at the injection site; Headache; Fever; This spontaneous case was reported by a consumer and describes the occurrence of LIMB DISCOMFORT (Can barely move her arm), DIARRHOEA (Diarrhea), PAIN (Body aches), INJECTION SITE SWELLING (Very swollen at the injection site) and HEADACHE (Headache) in a 55-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 004M20A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. The patient's past medical history included Suspected COVID-19 in July 2020. Concurrent medical conditions included No adverse event (Denies allergies). On 27-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 27-Jan-2021, the patient experienced LIMB DISCOMFORT (Can barely move her arm), DIARRHOEA (Diarrhea), PAIN (Body aches), INJECTION SITE SWELLING (Very swollen at the injection site), HEADACHE (Headache) and PYREXIA (Fever). The patient was treated with IBUPROFEN at an unspecified dose and frequency. At the time of the report, LIMB DISCOMFORT (Can barely move her arm), DIARRHOEA (Diarrhea), PAIN (Body aches), INJECTION SITE SWELLING (Very swollen at the injection site), HEADACHE (Headache) and PYREXIA (Fever) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown.

Other Meds:

Current Illness:

ID: 1580971
Sex: F
Age:
State: TX

Vax Date: 01/23/2021
Onset Date: 01/23/2021
Rec V Date: 08/18/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: she still has a dark bruise on her arm; This spontaneous case was reported by a consumer and describes the occurrence of INJECTION SITE BRUISING (she still has a dark bruise on her arm) 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 23-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 23-Jan-2021, the patient experienced INJECTION SITE BRUISING (she still has a dark bruise on her arm). At the time of the report, INJECTION SITE BRUISING (she still has a dark bruise on her arm) outcome was unknown. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown Route) was unknown.

Other Meds:

Current Illness:

ID: 1580972
Sex: F
Age: 82
State: NY

Vax Date: 01/23/2021
Onset Date: 01/25/2021
Rec V Date: 08/18/2021
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: Rash is a little bit itchy; Rash all over the body; This spontaneous case was reported by a consumer and describes the occurrence of RASH PRURITIC (Rash is a little bit itchy) and RASH (Rash all over the body) in an 82-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 038K20A) for COVID-19 vaccination. Concurrent medical conditions included Sensitive skin (Medical history reported as Sensitive skin/Fair skin.). On 23-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 25-Jan-2021, the patient experienced RASH PRURITIC (Rash is a little bit itchy) and RASH (Rash all over the body). At the time of the report, RASH PRURITIC (Rash is a little bit itchy) and RASH (Rash all over the body) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Most recent FOLLOW-UP information incorporated above includes: On 26-Jan-2021: ADR form contains NNI

Other Meds:

Current Illness: Sensitive skin (Medical history reported as Sensitive skin/Fair skin.)

ID: 1580973
Sex: M
Age:
State: TX

Vax Date: 02/11/2021
Onset Date: 02/11/2021
Rec V Date: 08/18/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Nausea

Symptoms: Nightsweats; Chills; This spontaneous case was reported by a consumer and describes the occurrence of NIGHT SWEATS (Nightsweats) and CHILLS (Chills) in a 68-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 024M20A) for COVID-19 vaccination. No medical history was provided by the reporter. On 11-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 11-Feb-2021, the patient experienced CHILLS (Chills). On 12-Feb-2021, the patient experienced NIGHT SWEATS (Nightsweats). On 11-Feb-2021, CHILLS (Chills) had resolved. On 14-Feb-2021, NIGHT SWEATS (Nightsweats) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. This case was linked to US-MODERNATX, INC.-MOD-2021-020483 (E2B Linked Report).; Sender's Comments: US-MODERNATX, INC.-MOD-2021-020483:MOD21-035131: Same reporter, reporter herself

Other Meds:

Current Illness:

ID: 1580974
Sex: F
Age:
State: MD

Vax Date: 01/21/2021
Onset Date: 01/21/2021
Rec V Date: 08/18/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Injection site pain

Symptoms: Loss of Appetite; Fatigue; Swelling near the injection site; Fever; Sore arm; Swollen Arm; This spontaneous case was reported by a non-health professional and describes the occurrence of PYREXIA (Fever), PAIN IN EXTREMITY (Sore arm), DECREASED APPETITE (Loss of Appetite), FATIGUE (Fatigue) and VACCINATION SITE SWELLING (Swelling near the injection site) in a 63-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. unknown and unknown) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. Concurrent medical conditions included Diabetes. Concomitant products included INSULIN for Diabetes. On 21-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 19-Feb-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 2 dosage form. On 21-Jan-2021, the patient experienced PAIN IN EXTREMITY (Sore arm) and PERIPHERAL SWELLING (Swollen Arm). On 19-Feb-2021, the patient experienced PYREXIA (Fever), DECREASED APPETITE (Loss of Appetite), FATIGUE (Fatigue) and VACCINATION SITE SWELLING (Swelling near the injection site). The patient was treated with PARACETAMOL (TYLENOL) at an unspecified dose and frequency. On 25-Jan-2021, PAIN IN EXTREMITY (Sore arm) and PERIPHERAL SWELLING (Swollen Arm) had resolved. At the time of the report, PYREXIA (Fever), DECREASED APPETITE (Loss of Appetite), FATIGUE (Fatigue) and VACCINATION SITE SWELLING (Swelling near the injection site) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) and mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown Route) was unknown. This case was linked to MOD-2021-020503 (E2B Linked Report).; Sender's Comments: MOD-2021-020503:Same patient, 1st dose

Other Meds: INSULIN

Current Illness: Diabetes

ID: 1580975
Sex: F
Age:
State: VA

Vax Date:
Onset Date:
Rec V Date: 08/18/2021
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: Shingles; This spontaneous case was reported by a consumer and describes the occurrence of HERPES ZOSTER (Shingles) 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 y the reporter. On an unknown date, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On an unknown date, the patient experienced HERPES ZOSTER (Shingles). At the time of the report, HERPES ZOSTER (Shingles) had not resolved.

Other Meds:

Current Illness:

ID: 1580976
Sex: F
Age: 45
State: CA

Vax Date: 08/14/2021
Onset Date: 08/16/2021
Rec V Date: 08/18/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Hot red skin at injection site with painful nodule under skin

Other Meds:

Current Illness:

ID: 1580977
Sex: F
Age: 45
State: AZ

Vax Date: 08/16/2021
Onset Date: 08/16/2021
Rec V Date: 08/18/2021
Hospital:

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

Lab Data:

Allergies: Contact allergy to metals

Symptom List: Tremor

Symptoms: Fever & chills began at 11:30pm the same day. Beginning 24 hours after the vaccine, I began getting burning in both knees and my left hip. That lasted for about 12 hours and seems to have subsided as of now.

Other Meds: Citalopram

Current Illness: None

ID: 1580978
Sex: M
Age: 75
State: TN

Vax Date: 01/19/2021
Onset Date: 01/19/2021
Rec V Date: 08/18/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Erythema, Pruritus

Symptoms: COVID-19; Up all night, couldn't sleep; Awful dry cough; Sore left shoulder; This spontaneous case was reported by a consumer and describes the occurrence of COVID-19 (COVID-19), INSOMNIA (Up all night, couldn't sleep), COUGH (Awful dry cough) and ARTHRALGIA (Sore left shoulder) in a 75-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 19-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 19-Jan-2021, the patient experienced ARTHRALGIA (Sore left shoulder). On 22-Jan-2021, the patient experienced INSOMNIA (Up all night, couldn't sleep) and COUGH (Awful dry cough). On 25-Jan-2021, the patient experienced COVID-19 (COVID-19). The patient was treated with DEXTROMETHORPHAN HYDROBROMIDE, GUAIFENESIN, PARACETAMOL, PSEUDOEPHEDRINE HYDROCHLORIDE (DAYQUIL) at a dose of 1 dosage form; DEXTROMETHORPHAN HYDROBROMIDE, DOXYLAMINE SUCCINATE, EPHEDRINE SULFATE, ETHANOL, PARACETAMOL (NYQUIL) at a dose of 1 dosage form; FLUTICASONE PROPIONATE (FLONASE [FLUTICASONE PROPIONATE]) at a dose of 1 dosage form and CETIRIZINE HYDROCHLORIDE (ZYRTEC ALLERGY) at a dose of 1 dosage form. On 24-Jan-2021, COUGH (Awful dry cough) had resolved. At the time of the report, COVID-19 (COVID-19), INSOMNIA (Up all night, couldn't sleep) and ARTHRALGIA (Sore left shoulder) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 25-Jan-2021, SARS-CoV-2 test: Positive. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown.

Other Meds:

Current Illness:

ID: 1580979
Sex: F
Age: 58
State: IL

Vax Date: 02/01/2021
Onset Date:
Rec V Date: 08/18/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Like burning chest; Chills; Sore throat; This spontaneous case was reported by a consumer and describes the occurrence of CHEST PAIN (Like burning chest), CHILLS (Chills) and OROPHARYNGEAL PAIN (Sore throat) in a 58-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 026L20A) for COVID-19 vaccination. Concurrent medical conditions included COPD. Concomitant products included SALBUTAMOL (ALBUTEROL HFA) for COPD. On 01-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 CHEST PAIN (Like burning chest), CHILLS (Chills) and OROPHARYNGEAL PAIN (Sore throat). At the time of the report, CHEST PAIN (Like burning chest), CHILLS (Chills) and OROPHARYNGEAL PAIN (Sore throat) had not resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown.

Other Meds: ALBUTEROL HFA

Current Illness: COPD

ID: 1580980
Sex: F
Age:
State:

Vax Date: 02/19/2021
Onset Date: 02/20/2021
Rec V Date: 08/18/2021
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: Limited range of motion (eg. cannot comb her hair); Extreme soreness at the arm where it was administered; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE PAIN (Extreme soreness at the arm where it was administered) and INJECTED LIMB MOBILITY DECREASED (Limited range of motion (eg. cannot comb her hair)) 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. On 19-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 20-Feb-2021, the patient experienced VACCINATION SITE PAIN (Extreme soreness at the arm where it was administered). On 21-Feb-2021, the patient experienced INJECTED LIMB MOBILITY DECREASED (Limited range of motion (eg. cannot comb her hair)). At the time of the report, VACCINATION SITE PAIN (Extreme soreness at the arm where it was administered) outcome was unknown and INJECTED LIMB MOBILITY DECREASED (Limited range of motion (eg. cannot comb her hair)) was resolving. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown.

Other Meds:

Current Illness:

ID: 1580981
Sex: F
Age: 73
State: CT

Vax Date: 02/19/2021
Onset Date: 02/20/2021
Rec V Date: 08/18/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Achy; Sore arm; Chills; Muscle pain; This spontaneous case was reported by a consumer and describes the occurrence of PAIN (Achy), PAIN IN EXTREMITY (Sore arm), CHILLS (Chills) and MYALGIA (Muscle pain) in a 73-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 011M20A) for COVID-19 vaccination. No medical history was provided by the reporter. On 19-Feb-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 2 dosage form. On 20-Feb-2021, the patient experienced PAIN (Achy), PAIN IN EXTREMITY (Sore arm), CHILLS (Chills) and MYALGIA (Muscle pain). The patient was treated with PARACETAMOL (TYLENOL) at an unspecified dose and frequency. At the time of the report, PAIN (Achy), PAIN IN EXTREMITY (Sore arm), CHILLS (Chills) and MYALGIA (Muscle pain) outcome was unknown.

Other Meds:

Current Illness:

ID: 1580982
Sex: F
Age:
State: NY

Vax Date: 01/08/2021
Onset Date: 01/08/2021
Rec V Date: 08/18/2021
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: lethargy; fever; chills; headache; This spontaneous case was reported by a health care professional and describes the occurrence of LETHARGY (lethargy), PYREXIA (fever), CHILLS (chills) and HEADACHE (headache) in a 28-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. Unknown) for COVID-19 vaccination. No medical history was provided by the reporter. On 08-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 08-Jan-2021, the patient experienced LETHARGY (lethargy), PYREXIA (fever), CHILLS (chills) and HEADACHE (headache). At the time of the report, LETHARGY (lethargy), PYREXIA (fever), CHILLS (chills) and HEADACHE (headache) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown Route) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown Route), the reporter did not provide any causality assessments.

Other Meds:

Current Illness:

ID: 1580983
Sex: F
Age: 65
State: NY

Vax Date: 02/13/2021
Onset Date: 02/13/2021
Rec V Date: 08/18/2021
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: Red; Itchy; Rash; Swollen; Tender; This spontaneous case was reported by a consumer and describes the occurrence of SWELLING (Swollen), TENDERNESS (Tender), ERYTHEMA (Red), PRURITUS (Itchy) and RASH (Rash) in a 65-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 015M20A) for COVID-19 vaccination. No medical history was provided by the reporter. Concomitant products included MULTIVITAMIN [VITAMINS NOS], CLONAZEPAM, CALCIUM and SERTRALINE HYDROCHLORIDE (ZOLOFT) for an unknown indication. On 13-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 13-Feb-2021, the patient experienced SWELLING (Swollen) and TENDERNESS (Tender). On an unknown date, the patient experienced ERYTHEMA (Red), PRURITUS (Itchy) and RASH (Rash). At the time of the report, SWELLING (Swollen), TENDERNESS (Tender), ERYTHEMA (Red), PRURITUS (Itchy) and RASH (Rash) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Treatment medications were not provided Most recent FOLLOW-UP information incorporated above includes: On 03-Aug-2021: Follow up received and contain non significant information.

Other Meds: MULTIVITAMIN [VITAMINS NOS]; CLONAZEPAM; CALCIUM; ZOLOFT

Current Illness:

ID: 1580984
Sex: F
Age: 76
State: WA

Vax Date: 02/15/2021
Onset Date: 02/20/2021
Rec V Date: 08/18/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Pain in extremity

Symptoms: Stiff neck; Extremely tired; Real bad itching on stomach and under arm; This spontaneous case was reported by a consumer and describes the occurrence of PRURITUS (Real bad itching on stomach and under arm), MUSCULOSKELETAL STIFFNESS (Stiff neck) and FATIGUE (Extremely tired) in a 76-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No medical history was provided by the reporter. On 15-Feb-2021, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 20-Feb-2021, the patient experienced MUSCULOSKELETAL STIFFNESS (Stiff neck). On an unknown date, the patient experienced PRURITUS (Real bad itching on stomach and under arm) and FATIGUE (Extremely tired). At the time of the report, PRURITUS (Real bad itching on stomach and under arm), MUSCULOSKELETAL STIFFNESS (Stiff neck) and FATIGUE (Extremely tired) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown.

Other Meds:

Current Illness:

ID: 1580985
Sex: F
Age: 74
State: MA

Vax Date: 01/19/2021
Onset Date: 01/19/2021
Rec V Date: 08/18/2021
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: Diagnosed with a case of shngles; Right eye began watering a lot; This spontaneous case was reported by a consumer (subsequently medically confirmed) and describes the occurrence of RETINAL DISORDER (Right eye began watering a lot) and HERPES ZOSTER (Diagnosed with a case of shngles) in a 74-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 028L20A) for COVID-19 vaccination. No medical history was provided by the reporter. On 19-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 19-Jan-2021, the patient experienced RETINAL DISORDER (Right eye began watering a lot). On 20-Jan-2021, the patient experienced HERPES ZOSTER (Diagnosed with a case of shngles). At the time of the report, RETINAL DISORDER (Right eye began watering a lot) and HERPES ZOSTER (Diagnosed with a case of shngles) was resolving. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown.

Other Meds:

Current Illness:

ID: 1580986
Sex: F
Age: 42
State: GA

Vax Date: 01/19/2021
Onset Date: 01/24/2021
Rec V Date: 08/18/2021
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: Swollen lymph nodes underneath arm and one below collarbone; Muscle twitches in both legs; This spontaneous case was reported by a consumer and describes the occurrence of LYMPHADENOPATHY (Swollen lymph nodes underneath arm and one below collarbone) and MUSCLE TWITCHING (Muscle twitches in both legs) in a 42-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 026L20A) for COVID-19 vaccination. No medical history was provided by the reporter. On 19-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 24-Jan-2021, the patient experienced LYMPHADENOPATHY (Swollen lymph nodes underneath arm and one below collarbone) and MUSCLE TWITCHING (Muscle twitches in both legs). At the time of the report, LYMPHADENOPATHY (Swollen lymph nodes underneath arm and one below collarbone) and MUSCLE TWITCHING (Muscle twitches in both legs) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown.

Other Meds:

Current Illness:

ID: 1580987
Sex: F
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 08/18/2021
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: Vaccine exposure during pregnancy; This spontaneous prospective pregnancy case was reported by a consumer and describes the occurrence of EXPOSURE DURING PREGNANCY (Vaccine exposure during pregnancy) 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 dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. Last menstrual period and estimated date of delivery were not provided. On an unknown date, the patient experienced EXPOSURE DURING PREGNANCY (Vaccine exposure during pregnancy). At the time of the report, EXPOSURE DURING PREGNANCY (Vaccine exposure during pregnancy) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No relevant concomitant medications were reported. No treatment information was provided.

Other Meds:

Current Illness:

ID: 1580988
Sex: F
Age: 74
State: KY

Vax Date: 02/17/2021
Onset Date: 02/20/2021
Rec V Date: 08/18/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Vomiting

Symptoms: If she touches the injection site is a little tender but not painful; Stomach sick; Chills; Vomiting; Extremely sick; Diarrhoea; Felt hot but had no fever; This spontaneous case was reported by a consumer and describes the occurrence of MALAISE (Extremely sick), DIARRHOEA (Diarrhoea), FEELING HOT (Felt hot but had no fever), ABDOMINAL DISCOMFORT (Stomach sick) and CHILLS (Chills) in a 74-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 006M20A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. Concurrent medical conditions included Diabetes, Blood pressure and Thyroid atrophy (.). On 17-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 20-Feb-2021, the patient experienced MALAISE (Extremely sick), DIARRHOEA (Diarrhoea), FEELING HOT (Felt hot but had no fever), CHILLS (Chills) and VOMITING (Vomiting). On 22-Feb-2021, the patient experienced ABDOMINAL DISCOMFORT (Stomach sick). On an unknown date, the patient experienced VACCINATION SITE PAIN (If she touches the injection site is a little tender but not painful). At the time of the report, MALAISE (Extremely sick), DIARRHOEA (Diarrhoea), FEELING HOT (Felt hot but had no fever), ABDOMINAL DISCOMFORT (Stomach sick), CHILLS (Chills), VOMITING (Vomiting) and VACCINATION SITE PAIN (If she touches the injection site is a little tender but not painful) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown.

Other Meds:

Current Illness: Blood pressure; Diabetes; Thyroid atrophy (.)

ID: 1580989
Sex: F
Age: 69
State: FL

Vax Date: 01/26/2021
Onset Date: 01/26/2021
Rec V Date: 08/18/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: has a bump in her left arm; had diarrhea; felt tired; Had some cold; sore left arm that went all the way to the neck; This spontaneous case was reported by an other health care professional and describes the occurrence of PAIN IN EXTREMITY (sore left arm that went all the way to the neck), NASOPHARYNGITIS (Had some cold), PERIPHERAL SWELLING (has a bump in her left arm), DIARRHOEA (had diarrhea) and FATIGUE (felt tired) in a 69-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 030L20A) for COVID-19 vaccination. The patient's past medical history included Back pain and Cholesterol. Concurrent medical conditions included Diabetes. On 26-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 26-Jan-2021, the patient experienced PAIN IN EXTREMITY (sore left arm that went all the way to the neck). On 28-Jan-2021, the patient experienced NASOPHARYNGITIS (Had some cold) and FATIGUE (felt tired). On 01-Feb-2021, the patient experienced PERIPHERAL SWELLING (has a bump in her left arm) and DIARRHOEA (had diarrhea). On 28-Jan-2021, PAIN IN EXTREMITY (sore left arm that went all the way to the neck) outcome was unknown. At the time of the report, NASOPHARYNGITIS (Had some cold), PERIPHERAL SWELLING (has a bump in her left arm), DIARRHOEA (had diarrhea) and FATIGUE (felt tired) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments.

Other Meds:

Current Illness:

ID: 1580990
Sex: M
Age: 86
State: PA

Vax Date: 02/17/2021
Onset Date: 02/17/2021
Rec V Date: 08/18/2021
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: Had Side Effects; Having a hard time urinating; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION COMPLICATION (Had Side Effects) and DYSURIA (Having a hard time urinating) in an 86-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 006M20A) for COVID-19 vaccination. No medical history was provided by the reporter. On 17-Feb-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 2 dosage form. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 17-Feb-2021, the patient experienced DYSURIA (Having a hard time urinating). On an unknown date, the patient experienced VACCINATION COMPLICATION (Had Side Effects). At the time of the report, VACCINATION COMPLICATION (Had Side Effects) and DYSURIA (Having a hard time urinating) had not resolved. Most recent FOLLOW-UP information incorporated above includes: On 22-Feb-2021: No specific follow-up information recorded.

Other Meds:

Current Illness:

ID: 1580991
Sex: F
Age: 35
State:

Vax Date: 01/17/2021
Onset Date: 01/23/2021
Rec V Date: 08/18/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Rash on the stomach/ rash all over chest, arms, thighs/ rashes keep on going away and coming back; hives all over stomach; This spontaneous case was reported by an other health care professional and describes the occurrence of URTICARIA (hives all over stomach) and RASH (Rash on the stomach/ rash all over chest, arms, thighs/ rashes keep on going away and coming back) in a 36-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 013L20A) for COVID-19 vaccination. The patient's past medical history included No adverse event. Concomitant products included ORAL CONTRACEPTIVE NOS for Birth control pill, BROMOCRIPTINE for an unknown indication. On 17-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 23-Jan-2021, the patient experienced URTICARIA (hives all over stomach). On an unknown date, the patient experienced RASH (Rash on the stomach/ rash all over chest, arms, thighs/ rashes keep on going away and coming back). The patient was treated with DIPHENHYDRAMINE HYDROCHLORIDE (BENADRYL A) for Adverse event, at an unspecified dose and frequency; PREDNISONE for Adverse event, at an unspecified dose and frequency and CETIRIZINE HYDROCHLORIDE (ZYRTEC HIVES RELIEF) for Hives, at a dose of UNK, q12h. At the time of the report, URTICARIA (hives all over stomach) and RASH (Rash on the stomach/ rash all over chest, arms, thighs/ rashes keep on going away and coming back) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments.

Other Meds: ORAL CONTRACEPTIVE NOS; BROMOCRIPTINE

Current Illness:

ID: 1580992
Sex: F
Age:
State: CT

Vax Date:
Onset Date:
Rec V Date: 08/18/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Arm was sore from 1st vaccine; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (Arm was sore from 1st vaccine) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The patient's past medical history included No adverse event (No reported medical history). 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 (Arm was sore from 1st vaccine). At the time of the report, PAIN IN EXTREMITY (Arm was sore from 1st vaccine) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No Treatment information was provided. Conmeds were not provided. Reporter did not allow further contact

Other Meds:

Current Illness:

ID: 1580993
Sex: M
Age: 46
State: TX

Vax Date: 12/31/2020
Onset Date: 01/28/2021
Rec V Date: 08/18/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Muscle spams in both low legs; Painful legs, goes up and down; This spontaneous case was reported by a consumer and describes the occurrence of MUSCLE SPASMS (Muscle spams in both low legs) and PAIN (Painful legs, goes up and down) in a 46-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 010M20A and 025L20A) for COVID-19 vaccination. No Medical History information was reported. On 31-Dec-2020, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 28-Jan-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 28-Jan-2021, the patient experienced MUSCLE SPASMS (Muscle spams in both low legs) and PAIN (Painful legs, goes up and down). At the time of the report, MUSCLE SPASMS (Muscle spams in both low legs) and PAIN (Painful legs, goes up and down) had not resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medications were reported. No treatment medications were provided by the reporter.

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 704,237

Page last modified: 26 October 2021 2:21am