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: 1581244
Sex: M
Age:
State: TN

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: Dysphagia, Epiglottitis

Symptoms: Heartburn; Vomiting; This spontaneous case was reported by a consumer and describes the occurrence of DYSPEPSIA (Heartburn) and VOMITING (Vomiting) 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 second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 2 dosage form. On an unknown date, the patient experienced DYSPEPSIA (Heartburn) and VOMITING (Vomiting). At the time of the report, DYSPEPSIA (Heartburn) had not resolved and VOMITING (Vomiting) outcome was unknown. Treatment information not provided.

Other Meds:

Current Illness:

ID: 1581245
Sex: F
Age: 54
State: NY

Vax Date: 01/06/2021
Onset Date: 01/06/2021
Rec V Date: 08/18/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Anxiety, Dyspnoea

Symptoms: Loss of Taste; Loss of Smell; Fatigue; Positive COVID-19 Test; Body Aches; Headache; This spontaneous case was reported by a consumer and describes the occurrence of SARS-COV-2 TEST POSITIVE (Positive COVID-19 Test), AGEUSIA (Loss of Taste), ANOSMIA (Loss of Smell), FATIGUE (Fatigue) and MYALGIA (Body Aches) in a 54-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 025J20A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 06-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 06-Jan-2021, the patient experienced MYALGIA (Body Aches) and HEADACHE (Headache). On 16-Jan-2021, the patient experienced SARS-COV-2 TEST POSITIVE (Positive COVID-19 Test). On 18-Jan-2021, the patient experienced AGEUSIA (Loss of Taste), ANOSMIA (Loss of Smell) and FATIGUE (Fatigue). On 09-Jan-2021, MYALGIA (Body Aches) and HEADACHE (Headache) had resolved. On 16-Jan-2021, SARS-COV-2 TEST POSITIVE (Positive COVID-19 Test) had resolved. At the time of the report, AGEUSIA (Loss of Taste), ANOSMIA (Loss of Smell) and FATIGUE (Fatigue) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 16-Jan-2021, SARS-CoV-2 test positive: Positive. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No concomitant medications provided. No treatment information provided.

Other Meds:

Current Illness:

ID: 1581246
Sex: F
Age: 61
State:

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

Symptoms: Severe reaction at the site; No appetite; Fogginess in the head; Fever; Nausea; Severe headache; This spontaneous case was reported by a nurse (subsequently medically confirmed) and describes the occurrence of INJECTION SITE REACTION (Severe reaction at the site), DECREASED APPETITE (No appetite), FEELING ABNORMAL (Fogginess in the head), PYREXIA (Fever) and NAUSEA (Nausea) in a 61-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 028L20A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. Concomitant products included LEVOTHYROXINE SODIUM (SYNTHROID) for an unknown indication. On 22-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 22-Jan-2021, the patient experienced INJECTION SITE REACTION (Severe reaction at the site), DECREASED APPETITE (No appetite), FEELING ABNORMAL (Fogginess in the head), PYREXIA (Fever), NAUSEA (Nausea) and HEADACHE (Severe headache). On 24-Jan-2021, INJECTION SITE REACTION (Severe reaction at the site), PYREXIA (Fever) and NAUSEA (Nausea) had resolved. At the time of the report, DECREASED APPETITE (No appetite) had resolved, FEELING ABNORMAL (Fogginess in the head) had not resolved and HEADACHE (Severe headache) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. Treatment information not provided.

Other Meds: SYNTHROID

Current Illness:

ID: 1581247
Sex: F
Age: 75
State: FL

Vax Date: 01/13/2021
Onset Date: 01/13/2021
Rec V Date: 08/18/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: 2nd dose because she wanted to take the second shot and has been refused by healthcare providers due to her reaction to the first dose.; hypersensitivity; joint pain both knees; joint pain right shoulder/joint pain left hand; very tired/sleepy; blurred vision; Blood pressure high; flush left side of face; Light-headedness; back of head/neck soreness; This spontaneous case was reported by a consumer (subsequently medically confirmed) and describes the occurrence of VISION BLURRED (blurred vision), HYPERTENSION (Blood pressure high), FLUSHING (flush left side of face), DIZZINESS (Light-headedness) and NECK PAIN (back of head/neck soreness) in a 75-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 011L20A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. Concurrent medical conditions included Allergy (Patient is allergic to Propofol which contains polysorbate (gets flu-like symptoms) and Allergy (Patient is also allergic to Demerol.). On 13-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 13-Jan-2021, the patient experienced VISION BLURRED (blurred vision), HYPERTENSION (Blood pressure high), FLUSHING (flush left side of face), DIZZINESS (Light-headedness), NECK PAIN (back of head/neck soreness), ARTHRALGIA (joint pain both knees), ARTHRALGIA (joint pain right shoulder/joint pain left hand) and FATIGUE (very tired/sleepy). On an unknown date, the patient experienced PRODUCT DOSE OMISSION ISSUE (2nd dose because she wanted to take the second shot and has been refused by healthcare providers due to her reaction to the first dose.) and HYPERSENSITIVITY (hypersensitivity). On 13-Jan-2021, VISION BLURRED (blurred vision), HYPERTENSION (Blood pressure high), FLUSHING (flush left side of face), DIZZINESS (Light-headedness), NECK PAIN (back of head/neck soreness), ARTHRALGIA (joint pain right shoulder/joint pain left hand) and FATIGUE (very tired/sleepy) had resolved. At the time of the report, PRODUCT DOSE OMISSION ISSUE (2nd dose because she wanted to take the second shot and has been refused by healthcare providers due to her reaction to the first dose.) and HYPERSENSITIVITY (hypersensitivity) outcome was unknown and ARTHRALGIA (joint pain both knees) was resolving. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 13-Jan-2021, Blood pressure measurement: 179/89 (High) shot up to 179/89, 172/89 (High) After 15 minutes172/89., 163 (High) After 30 minutes 163/8?. and 121/85 (normal) At 2:00 BP was normal 121/85.. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No treatment information and concomitant medication reported. Most recent FOLLOW-UP information incorporated above includes: On 22-Jun-2021: Patient stated that she was allergic to vaccine and asked about the vaccine compounds and product dose omission was reported.Contact information updated.

Other Meds:

Current Illness: Allergy (Patient is also allergic to Demerol.); Allergy (Patient is allergic to Propofol which contains polysorbate (gets flu-like symptoms)

ID: 1581248
Sex: M
Age:
State: FL

Vax Date: 01/25/2021
Onset Date: 02/22/2021
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 erythema, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: hot flushing; arm soreness at vaccination site; This spontaneous case was reported by a consumer and describes the occurrence of HOT FLUSH (hot flushing) and VACCINATION SITE PAIN (arm soreness at vaccination site) in a 77-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) 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 22-Feb-2021, the patient experienced HOT FLUSH (hot flushing) and VACCINATION SITE PAIN (arm soreness at vaccination site). On 24-Feb-2021, HOT FLUSH (hot flushing) and VACCINATION SITE PAIN (arm soreness at vaccination site) had resolved. No concomitant product use was reported. No treatment information was provided This case was linked to MOD-2021-021490 (Patient Link). Most recent FOLLOW-UP information incorporated above includes: On 25-Feb-2021: TCR received on 25-FEB-2021. Updated patient identifiers. Added new events

Other Meds:

Current Illness:

ID: 1581249
Sex: M
Age:
State: FL

Vax Date: 01/25/2021
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: Chills, Confusional state, Eye inflammation, Headache, Laboratory test

Symptoms: arm soreness at vaccination site; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE PAIN (arm soreness at vaccination site) in a 77-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) 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) (unknown route) dosage was changed to 1 dosage form. On 25-Jan-2021, the patient experienced VACCINATION SITE PAIN (arm soreness at vaccination site). On 27-Jan-2021, VACCINATION SITE PAIN (arm soreness at vaccination site) had resolved. Not Provided DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 11-Feb-2021, SARS-CoV-2 test: Positive. 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. Concomitant medication and treatment drug were not reported. This case was linked to MOD-2021-021557 (Patient Link).

Other Meds:

Current Illness:

ID: 1581250
Sex: F
Age: 74
State: CA

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

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

Lab Data:

Allergies:

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Arm was itching; Arm is now red; white spot in middle of the redness that is halfway down her arm (between shoulder and elbow.); Pain at the injection site; This spontaneous case was reported by a consumer and describes the occurrence of PRURITUS (Arm was itching), ERYTHEMA (Arm is now red), RASH MACULAR (white spot in middle of the redness that is halfway down her arm (between shoulder and elbow.)) and VACCINATION SITE PAIN (Pain at the injection site) in a 74-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 042620A) for COVID-19 vaccination. Concurrent medical conditions included Drug allergy. Concomitant products included VITAMINS NOS for an unknown indication. On 20-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 20-Jan-2021, the patient experienced VACCINATION SITE PAIN (Pain at the injection site). On 26-Jan-2021, the patient experienced PRURITUS (Arm was itching), ERYTHEMA (Arm is now red) and RASH MACULAR (white spot in middle of the redness that is halfway down her arm (between shoulder and elbow.)). At the time of the report, PRURITUS (Arm was itching), ERYTHEMA (Arm is now red), RASH MACULAR (white spot in middle of the redness that is halfway down her arm (between shoulder and elbow.)) 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. The patient was concerned as white spot in middle of the redness that was halfway down her arm (shoulder and elbow) was few inches away from the injection site.

Other Meds: VITAMINS NOS

Current Illness: Drug allergy

ID: 1581251
Sex: M
Age: 71
State: AZ

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

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

Lab Data:

Allergies:

Symptom List: Pharyngeal swelling

Symptoms: Fatigue; 99 F temperature; muscle pain; soreness in the arm; This spontaneous case was reported by a patient family member or friend and describes the occurrence of PAIN IN EXTREMITY (soreness in the arm), FATIGUE (Fatigue), BODY TEMPERATURE INCREASED (99 F temperature) and MYALGIA (muscle pain) in a 71-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 011L20A) for COVID-19 vaccination. The patient's past medical history included Adverse event. On 19-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 19-Feb-2021, the patient experienced PAIN IN EXTREMITY (soreness in the arm). On 20-Feb-2021, the patient experienced FATIGUE (Fatigue), BODY TEMPERATURE INCREASED (99 F temperature) and MYALGIA (muscle pain). At the time of the report, PAIN IN EXTREMITY (soreness in the arm), FATIGUE (Fatigue), BODY TEMPERATURE INCREASED (99 F temperature) and MYALGIA (muscle pain) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medications reported. No treatment information provided.

Other Meds:

Current Illness:

ID: 1581252
Sex: M
Age:
State: FL

Vax Date: 01/25/2021
Onset Date: 02/22/2021
Rec V Date: 08/18/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: periods of hot flushing; arm soreness at vaccination site; This spontaneous case was reported by a consumer and describes the occurrence of HOT FLUSH (periods of hot flushing) and VACCINATION SITE PAIN (arm soreness at vaccination site) in a 77-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) 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) (unknown route) 1 dosage form. On 22-Feb-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 22-Feb-2021, the patient experienced HOT FLUSH (periods of hot flushing) and VACCINATION SITE PAIN (arm soreness at vaccination site). On 24-Feb-2021, HOT FLUSH (periods of hot flushing) and VACCINATION SITE PAIN (arm soreness at vaccination site) had resolved. Action taken with mRNA-1273 was not applicable. No concomitant medications reported by reporter. No Treatment medication was taken. This case was linked to MOD-2021-021554 (Patient Link). Most recent FOLLOW-UP information incorporated above includes: On 25-Feb-2021: TCR received on 25-FEB-2021. Updated patient identifiers. Added new events. Information about dose 1 and dose 2

Other Meds:

Current Illness:

ID: 1581253
Sex: F
Age:
State: IL

Vax Date:
Onset Date: 01/14/2021
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: Arm sore; Headache; Tired; This spontaneous case was reported by a consumer and describes the occurrence of in a 60-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 reaction. On 13-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On an unknown date, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medications reported. Treatment included Aspirin

Other Meds:

Current Illness:

ID: 1581254
Sex: F
Age: 55
State: DE

Vax Date: 01/16/2021
Onset Date: 02/24/2021
Rec V Date: 08/18/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: could feel heat from both legs; hands freezing; soft bowl movements; fever of 101f; fatigued; This spontaneous case was reported by a consumer and describes the occurrence of FEELING HOT (could feel heat from both legs), PERIPHERAL COLDNESS (hands freezing), DIARRHOEA (soft bowl movements), PYREXIA (fever of 101f) and FATIGUE (fatigued) in a 56-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 013M20A and 011J20A) for COVID-19 vaccination. The patient's past medical history included No adverse event (No adverse event history). On 16-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 23-Feb-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 24-Feb-2021, the patient experienced FEELING HOT (could feel heat from both legs), PERIPHERAL COLDNESS (hands freezing), DIARRHOEA (soft bowl movements), PYREXIA (fever of 101f) and FATIGUE (fatigued). At the time of the report, FEELING HOT (could feel heat from both legs), PERIPHERAL COLDNESS (hands freezing), DIARRHOEA (soft bowl movements), PYREXIA (fever of 101f) and FATIGUE (fatigued) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 24-Feb-2021, Pyrexia: fever of 101 F. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant medications reported. No treatment information provided.

Other Meds:

Current Illness:

ID: 1581255
Sex: M
Age: 76
State: NY

Vax Date: 02/18/2021
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: Rash, Urticaria

Symptoms: covid positive test; Lost taste; Weakness; cough; This spontaneous case was reported by a consumer and describes the occurrence of SARS-COV-2 TEST POSITIVE (covid positive test), COUGH (cough), ASTHENIA (Weakness) and AGEUSIA (Lost taste) in a 76-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 013L20A) for COVID-19 vaccination. The patient's past medical history included Prediabetes since an unknown date and Guillain Barre syndrome (GBS 35 years ago). On 18-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 19-Jan-2021, the patient experienced COUGH (cough). On 20-Jan-2021, the patient experienced ASTHENIA (Weakness). On 24-Jan-2021, the patient experienced SARS-COV-2 TEST POSITIVE (covid positive test) and AGEUSIA (Lost taste). The patient was treated with BENZONATATE (oral) for Adverse event, at a dose of 100 mg. At the time of the report, SARS-COV-2 TEST POSITIVE (covid positive test), COUGH (cough), ASTHENIA (Weakness) and AGEUSIA (Lost taste) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 24-Jan-2021, SARS-CoV-2 test: Positive. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No relevant Concomitant medications were reported. This case was received via an unknown source (no reference has been entered for a health authority or license partner) on 22-Feb-2021 and was forwarded to Moderna on 23-Feb-2021. This spontaneous case was reported by a consumer and describes the occurrence of SARS-COV-2 TEST POSITIVE (covid positive test), COUGH (cough), ASTHENIA (Weakness) and AGEUSIA (Lost taste) in a 76-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 013L20A) for COVID-19 vaccination. The patient's past medical history included Prediabetes since an unknown date and Guillain Barre syndrome (GBS 35 years ago). On 18-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 19-Jan-2021, the patient experienced COUGH (cough). On 20-Jan-2021, the patient experienced ASTHENIA (Weakness). On 24-Jan-2021, the patient experienced SARS-COV-2 TEST POSITIVE (covid positive test) and AGEUSIA (Lost taste). The patient was treated with BENZONATATE (oral) for Adverse event, at a dose of 100 mg. At the time of the report, SARS-COV-2 TEST POSITIVE (covid positive test), COUGH (cough), ASTHENIA (Weakness) and AGEUSIA (Lost taste) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 24-Jan-2021, SARS-CoV-2 test: Positive. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No relevant Concomitant medications were reported.

Other Meds:

Current Illness: Prediabetes

ID: 1581256
Sex: F
Age: 59
State: CT

Vax Date: 01/12/2021
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: Blood pressure decreased, Chest pain, Chills, Confusional state, Decreased appetite

Symptoms: Itchy rash; Rash under her bra line flat dots some are big and some are small/rash on legs/rash on stomach area; Red circle at the injection site; Left arm became swollen; Left arm became warm; COVID arm; Left arm gradually turned pink; Left arm itchy; This spontaneous case was reported by a consumer and describes the occurrence of PRURITUS (Left arm itchy), PERIPHERAL SWELLING (Left arm became swollen), SKIN WARM (Left arm became warm), VACCINATION SITE REACTION (COVID arm) and ERYTHEMA (Left arm gradually turned pink) in a 60-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 039K20A and 004M20A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. Concurrent medical conditions included Cholesterol. On 12-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) .5 ml. On 09-Feb-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to .5 ml. On 19-Jan-2021, the patient experienced PRURITUS (Left arm itchy). On 20-Jan-2021, the patient experienced PERIPHERAL SWELLING (Left arm became swollen), SKIN WARM (Left arm became warm), VACCINATION SITE REACTION (COVID arm), ERYTHEMA (Left arm gradually turned pink) and VACCINATION SITE ERYTHEMA (Red circle at the injection site). On an unknown date, the patient experienced RASH PRURITIC (Itchy rash) and RASH (Rash under her bra line flat dots some are big and some are small/rash on legs/rash on stomach area). On 23-Jan-2021, PRURITUS (Left arm itchy), PERIPHERAL SWELLING (Left arm became swollen), SKIN WARM (Left arm became warm), VACCINATION SITE REACTION (COVID arm), ERYTHEMA (Left arm gradually turned pink) and VACCINATION SITE ERYTHEMA (Red circle at the injection site) had resolved. At the time of the report, RASH PRURITIC (Itchy rash) and RASH (Rash under her bra line flat dots some are big and some are small/rash on legs/rash on stomach area) outcome was unknown. Products known to have been used by the patient, within two weeks prior to the event, included unknown cholesterol medication. Treatment for the event included lubriderm, acetaminophen and maximum strength topical cortisone. This case was linked to MOD-2021-057241 (Patient Link). Reporter did not allow further contact Most recent FOLLOW-UP information incorporated above includes: On 22-Feb-2021: NNI.

Other Meds:

Current Illness: Cholesterol

ID: 1581257
Sex: F
Age:
State: FL

Vax Date: 02/13/2021
Onset Date: 02/22/2021
Rec V Date: 08/18/2021
Hospital:

Vax Type:
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Vax Route:
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Lab Data:

Allergies:

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

Symptoms: Itchy rash; This spontaneous case was reported by a consumer and describes the occurrence of RASH PRURITIC (Itchy rash) in a 91-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 030M20A) for COVID-19 vaccination. The patient's past medical history included No adverse event (No medical history reported.). On 13-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 22-Feb-2021, the patient experienced RASH PRURITIC (Itchy rash). At the time of the report, RASH PRURITIC (Itchy rash) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Treatment included Sarna lotion to relief itch.

Other Meds:

Current Illness:

ID: 1581258
Sex: F
Age: 31
State: CA

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

Vax Type:
Manufacturer:
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Lab Data:

Allergies:

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

Symptoms: Swollen at injection site; Itching at injection site; Hives towards neck; Tiny muscle pain at injection site; This spontaneous case was reported by a consumer and describes the occurrence of INJECTION SITE PAIN (Tiny muscle pain at injection site), INJECTION SITE SWELLING (Swollen at injection site), INJECTION SITE PRURITUS (Itching at injection site) and URTICARIA (Hives towards neck) in a 31-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The patient's past medical history included No adverse event. Concomitant products included METHOTREXATE, MELOXICAM, Plaquenil and Folic acid 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 21-Jan-2021, the patient experienced INJECTION SITE PAIN (Tiny muscle pain at injection site). On 29-Jan-2021, the patient experienced INJECTION SITE SWELLING (Swollen at injection site), INJECTION SITE PRURITUS (Itching at injection site) and URTICARIA (Hives towards neck). At the time of the report, INJECTION SITE PAIN (Tiny muscle pain at injection site), INJECTION SITE SWELLING (Swollen at injection site), INJECTION SITE PRURITUS (Itching at injection site) and URTICARIA (Hives towards neck) outcome was unknown. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Treatment included Steroids

Other Meds: METHOTREXATE; MELOXICAM; Plaquenil; Folic acid

Current Illness:

ID: 1581259
Sex: F
Age: 78
State: MA

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

Vax Type:
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Lab Data:

Allergies:

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

Symptoms: blood would not clot; Debilitating joint pain/weak joints were extremely sore; Back really itched; uncomfortable; felt achy; This spontaneous case was reported by a consumer and describes the occurrence of PRURITUS (Back really itched), COAGULOPATHY (blood would not clot), DISCOMFORT (uncomfortable), MYALGIA (felt achy) and ARTHRALGIA (Debilitating joint pain/weak joints were extremely sore) in a 78-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 032620A) for COVID-19 vaccination. The patient's past medical history included Lymphoma. Concurrent medical conditions included Arthritis NOS. Concomitant products included GABAPENTIN for Arthritis, ATROPINE SULFATE, DIPHENOXYLATE HYDROCHLORIDE (DIPHENOXYLATE/ATROPINE), VITAMIN B NOS, LOPERAMIDE, NAPROXEN, PARACETAMOL (TYLENOL) and VITAMIN D NOS 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 29-Jan-2021, the patient experienced PRURITUS (Back really itched), DISCOMFORT (uncomfortable) and MYALGIA (felt achy). On 30-Jan-2021, the patient experienced ARTHRALGIA (Debilitating joint pain/weak joints were extremely sore). On 04-Feb-2021, the patient experienced COAGULOPATHY (blood would not clot). At the time of the report, PRURITUS (Back really itched), COAGULOPATHY (blood would not clot), DISCOMFORT (uncomfortable), MYALGIA (felt achy) and ARTHRALGIA (Debilitating joint pain/weak joints were extremely sore) had resolved. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 04-Feb-2021, Blood test: abnormal (abnormal) pre-operation bloodwork done and result showed her blood would not clot. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Due to bloodwork result ,Patient scheduled lung surgery on 05-Feb-2021 which had canceled. A few lymph nodes were removed robotically and lung nodule removed robotically on 19-Feb-2021. No relevant concomitant medications were reported. No treatment information was provided. Most recent FOLLOW-UP information incorporated above includes: On 05-Aug-2021: Follow-up received: New events added and event outcome updated, concomitant medications added.

Other Meds: DIPHENOXYLATE/ATROPINE; VITAMIN B NOS; GABAPENTIN; LOPERAMIDE; NAPROXEN; TYLENOL; VITAMIN D NOS

Current Illness: Arthritis NOS

ID: 1581260
Sex: U
Age:
State:

Vax Date: 02/12/2021
Onset Date:
Rec V Date: 08/18/2021
Hospital:

Vax Type:
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Lab Data:

Allergies:

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

Symptoms: Headache; Nausea; 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 HEADACHE (Headache) and NAUSEA (Nausea) 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 12-Feb-2021, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On an unknown date, the patient experienced HEADACHE (Headache) and NAUSEA (Nausea). At the time of the report, HEADACHE (Headache) and NAUSEA (Nausea) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medications reported. No treatment information provided.

Other Meds:

Current Illness:

ID: 1581261
Sex: M
Age: 63
State: MN

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

Vax Type:
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Lab Data:

Allergies:

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Feeling groggy; Nauseas; High blood pressure (160/80); Arm was swelling; Dizziness; Fatigue/tired; Achiness; Fever of 101.6 F; This spontaneous case was reported by a consumer and describes the occurrence of BLOOD PRESSURE INCREASED (High blood pressure (160/80)), PERIPHERAL SWELLING (Arm was swelling), FEELING ABNORMAL (Feeling groggy), DIZZINESS (Dizziness) and FATIGUE (Fatigue/tired) in a 63-year-old male 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 Drug allergy (Allergic to lisinopril, chlorothiazide and cleocin.), Penicillin allergy, Hypertension and Prediabetes. Concomitant products included AMLODIPINE, METOPROLOL and LOSARTAN for an unknown indication. On 18-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 18-Feb-2021, the patient experienced BLOOD PRESSURE INCREASED (High blood pressure (160/80)), PERIPHERAL SWELLING (Arm was swelling), DIZZINESS (Dizziness), FATIGUE (Fatigue/tired), MYALGIA (Achiness) and PYREXIA (Fever of 101.6 F). On 19-Feb-2021, the patient experienced FEELING ABNORMAL (Feeling groggy) and NAUSEA (Nauseas). At the time of the report, BLOOD PRESSURE INCREASED (High blood pressure (160/80)), PERIPHERAL SWELLING (Arm was swelling), FEELING ABNORMAL (Feeling groggy), DIZZINESS (Dizziness), FATIGUE (Fatigue/tired), MYALGIA (Achiness), PYREXIA (Fever of 101.6 F) and NAUSEA (Nauseas) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 18-Feb-2021, Blood pressure measurement: 160/80 High. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Treatment included Tylenol

Other Meds: AMLODIPINE; METOPROLOL; LOSARTAN

Current Illness: Drug allergy (Allergic to lisinopril, chlorothiazide and cleocin.); Hypertension; Penicillin allergy; Prediabetes

ID: 1581262
Sex: F
Age:
State: GA

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

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Lab Data:

Allergies:

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Swollen lymphnodes in left side of the neck; An acceleration in her heart rate; Twinges of pain in her chest; This spontaneous case was reported by a consumer and describes the occurrence of TACHYCARDIA (An acceleration in her heart rate), CHEST PAIN (Twinges of pain in her chest) and LYMPHADENOPATHY (Swollen lymphnodes in left side of the neck) 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. On 17-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 17-Feb-2021, the patient experienced TACHYCARDIA (An acceleration in her heart rate) and CHEST PAIN (Twinges of pain in her chest). On 22-Feb-2021, the patient experienced LYMPHADENOPATHY (Swollen lymphnodes in left side of the neck). On 17-Feb-2021, TACHYCARDIA (An acceleration in her heart rate) and CHEST PAIN (Twinges of pain in her chest) had resolved. At the time of the report, LYMPHADENOPATHY (Swollen lymphnodes in left side of the neck) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medications reported. No treatment information provided.

Other Meds:

Current Illness:

ID: 1581263
Sex: F
Age: 73
State: FL

Vax Date: 01/09/2021
Onset Date: 01/16/2021
Rec V Date: 08/18/2021
Hospital:

Vax Type:
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Lab Data:

Allergies:

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

Symptoms: Itching at injection site; Red bump at injection site; Itching in the armpit of the injection; Burning sensation skin; Burning sensation in the arm pit; This spontaneous case was reported by a consumer and describes the occurrence of INJECTION SITE PRURITUS (Itching at injection site), INJECTION SITE ERYTHEMA (Red bump at injection site), PRURITUS (Itching in the armpit of the injection), SKIN BURNING SENSATION (Burning sensation skin) and SKIN BURNING SENSATION (Burning sensation in the arm pit) in a 73-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 039K20A) for COVID-19 vaccination. The patient's past medical history included Blood pressure high since an unknown date and Type 2 diabetes mellitus since an unknown date. Concurrent medical conditions included Iodine allergy. Concomitant products included LOSARTAN, METFORMIN, NEBIVOLOL HYDROCHLORIDE (BYSTOLIC) and INSULIN for an unknown indication. On 09-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 16-Jan-2021, the patient experienced INJECTION SITE PRURITUS (Itching at injection site), INJECTION SITE ERYTHEMA (Red bump at injection site), PRURITUS (Itching in the armpit of the injection), SKIN BURNING SENSATION (Burning sensation skin) and SKIN BURNING SENSATION (Burning sensation in the arm pit). On 20-Jan-2021, INJECTION SITE PRURITUS (Itching at injection site), INJECTION SITE ERYTHEMA (Red bump at injection site) and PRURITUS (Itching in the armpit of the injection) had resolved. At the time of the report, SKIN BURNING SENSATION (Burning sensation skin) and SKIN BURNING SENSATION (Burning sensation in the arm pit) had not resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Treatment included Benadryl

Other Meds: LOSARTAN; METFORMIN; BYSTOLIC; INSULIN

Current Illness: Blood pressure high; Iodine allergy; Type 2 diabetes mellitus

ID: 1581264
Sex: F
Age: 68
State: NC

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

Vax Type:
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Lab Data:

Allergies:

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

Symptoms: Felt Cold; Chills; Aches; Headache; This spontaneous case was reported by a consumer and describes the occurrence of FEELING COLD (Felt Cold), CHILLS (Chills), MYALGIA (Aches) and HEADACHE (Headache) in a 68-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 024M20A) for COVID-19 vaccination. The patient's past medical history included No adverse event (No medical history reported.). On 19-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 19-Feb-2021, the patient experienced FEELING COLD (Felt Cold), CHILLS (Chills), MYALGIA (Aches) and HEADACHE (Headache). On 19-Feb-2021, FEELING COLD (Felt Cold), CHILLS (Chills), MYALGIA (Aches) and HEADACHE (Headache) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medications reported. Treatment included Tylenoll

Other Meds:

Current Illness:

ID: 1581265
Sex: M
Age: 70
State: IL

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

Vax Type:
Manufacturer:
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Lab Data:

Allergies:

Symptom List: Unevaluable event

Symptoms: a little swelling; Pain about a 1.5 or 2 out of 10; Fatigue; Insomnia; This spontaneous case was reported by a nurse and describes the occurrence of SWELLING (a little swelling), PAIN (Pain about a 1.5 or 2 out of 10), INSOMNIA (Insomnia) and FATIGUE (Fatigue) in a 70-year-old male 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 (No prior medical history reported). On 23-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. In January 2021, the patient experienced INSOMNIA (Insomnia). On 24-Jan-2021, the patient experienced SWELLING (a little swelling), PAIN (Pain about a 1.5 or 2 out of 10) and FATIGUE (Fatigue). On 25-Jan-2021, PAIN (Pain about a 1.5 or 2 out of 10) and INSOMNIA (Insomnia) had resolved. At the time of the report, SWELLING (a little swelling) and FATIGUE (Fatigue) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter considered INSOMNIA (Insomnia) and FATIGUE (Fatigue) to be possibly related. No further causality assessments were provided for SWELLING (a little swelling) and PAIN (Pain about a 1.5 or 2 out of 10). Treatment included Pt preemptively took 800 mg of ibuprofen about 1 hour prior to vaccination. No concomitant medications reported. This case was linked to MOD-2021-018447 (Patient Link).

Other Meds:

Current Illness:

ID: 1581266
Sex: F
Age: 79
State: FL

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

Vax Type:
Manufacturer:
Vax Name:
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Lab Data:

Allergies:

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

Symptoms: Rash on left arm; Swelling; Pain at injection; This spontaneous case was reported by a consumer and describes the occurrence of INJECTION SITE PAIN (Pain at injection), INJECTION SITE RASH (Rash on left arm) and INJECTION SITE SWELLING (Swelling) in a 79-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 031L20A) for COVID-19 vaccination. 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 INJECTION SITE PAIN (Pain at injection) and INJECTION SITE SWELLING (Swelling). On 13-Feb-2021, the patient experienced INJECTION SITE RASH (Rash on left arm). The patient was treated with HYDROCORTISONE at a dose of UNK UNK, tid. On 12-Feb-2021, INJECTION SITE PAIN (Pain at injection) and INJECTION SITE SWELLING (Swelling) had resolved. At the time of the report, INJECTION SITE RASH (Rash on left arm) had resolved. 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: 1581267
Sex: F
Age: 63
State: GA

Vax Date: 01/28/2021
Onset Date: 02/11/2021
Rec V Date: 08/18/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
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Lab Data:

Allergies:

Symptom List: Injection site pain, Pain

Symptoms: Hot arm; 2 inches size redness at the arm; Swollen arm; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE WARMTH (Hot arm), INJECTION SITE ERYTHEMA (2 inches size redness at the arm) and VACCINATION SITE SWELLING (Swollen arm) in a 63-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 028L20A) for COVID-19 vaccination. The patient's past medical history included No adverse reaction. On 28-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 11-Feb-2021, the patient experienced VACCINATION SITE WARMTH (Hot arm), INJECTION SITE ERYTHEMA (2 inches size redness at the arm) and VACCINATION SITE SWELLING (Swollen arm). At the time of the report, VACCINATION SITE WARMTH (Hot arm), INJECTION SITE ERYTHEMA (2 inches size redness at the arm) and VACCINATION SITE SWELLING (Swollen arm) 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. Reporter did not allow further contact

Other Meds:

Current Illness:

ID: 1581268
Sex: M
Age:
State: NJ

Vax Date: 01/22/2021
Onset Date: 01/12/2021
Rec V Date: 08/18/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Injection site pain, Menorrhagia

Symptoms: achy; tired; Felt like flu, achy and tired; This spontaneous case was reported by a consumer and describes the occurrence of INFLUENZA LIKE ILLNESS (Felt like flu, achy and tired), PAIN (achy) and FATIGUE (tired) in a male patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. Previously administered products included for Flu: flu shot on 12-Jan-2021. On 22-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 12-Jan-2021, the patient experienced INFLUENZA LIKE ILLNESS (Felt like flu, achy and tired). On 23-Jan-2021, the patient experienced PAIN (achy) and FATIGUE (tired). On 24-Jan-2021, PAIN (achy) and FATIGUE (tired) had resolved. At the time of the report, INFLUENZA LIKE ILLNESS (Felt like flu, achy and tired) 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 MOD-2021-006595 (Patient Link).

Other Meds:

Current Illness:

ID: 1581269
Sex: F
Age:
State:

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: Arthralgia, Chills, Headache, Mobility decreased, Myalgia

Symptoms: Laid around all day yesterday; arm much sorer; 2-3 hours of chills during the night; This spontaneous case was reported by a consumer and describes the occurrence of HYPERSOMNIA (Laid around all day yesterday), AXILLARY PAIN (arm much sorer) and CHILLS (2-3 hours of chills during the night) in an elderly female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. 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 AXILLARY PAIN (arm much sorer) and CHILLS (2-3 hours of chills during the night). On 21-Feb-2021, the patient experienced HYPERSOMNIA (Laid around all day yesterday). On 20-Feb-2021, CHILLS (2-3 hours of chills during the night) had resolved. On 21-Feb-2021, HYPERSOMNIA (Laid around all day yesterday) had resolved. At the time of the report, AXILLARY PAIN (arm much sorer) was resolving. No relevant concomitant medications were reported. Treatment information was not provided.

Other Meds:

Current Illness:

ID: 1581270
Sex: F
Age: 71
State: NY

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

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

Lab Data:

Allergies:

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Large red lump at the injection site; Little itchy in the area the vaccine was administered; Chills; Felt very tired; A spontaneous report was received from a consumer concerning a 71 years old female patient who had received Moderna's COVID-19 vaccine (mRNA-1273) and experienced some chills, felt very tired/fatigue and had a little itchy in the area the vaccine was administered/ injection site pruritus, large red lump at the injection site/injection site mass. The patient's medical history as reported by the reporter included, the patient was allergic to aspirin and had high cholesterol. Concomitant medications used by the patient were citalopram, carbamazepine, and vitamins. On 18 Jan 2021, prior to the onset of the events, the patient had received first of their two planned doses of mRNA-1273 (Lot number: 013-204) through unknown route on left arm for prophylaxis of COVID-19 infection. On 18 Jan 2021, patient experienced some chills, felt very tired and had a little itchy in the area the where the vaccine was administered. On 26 Jan 2021, the patient woke up with a large red lump at the injection site and it was very very itchy. The itchiness was driving her nuts and patient consulted her pharmacist about delayed reactions to the vaccine, and pharmacist prescribed Benadryl, a Hydrocortisone cream and ice patchs, and had encouraged her to report this symptoms. On an unknown date, on the day of reporting the injection site became lighter and softer, not the big, round, hard red lump that she had a few days ago. Treatment activities were done with diphenhydramine, hydrocortisone cream, ice patch. Action taken with mRNA-1273 in response to the events was unknown. The outcome of events, experienced some chills, felt very tired, and had a little itchy in the area the vaccine was administered, large red lump at the injection site were unknown.

Other Meds: CARBAMAZEPINE; CITALOPRAM; VITAMINS;AMINO ACIDS

Current Illness: Cholesterol (Patient has high cholesterol); Drug allergy (asprin)

ID: 1581271
Sex: M
Age:
State: NJ

Vax Date: 03/10/2021
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: Chills, Fatigue, Headache, Myalgia

Symptoms: SORE ARM; STIFF MUSCLES; CHILLS; FEVER; HEADACHES; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (SORE ARM), MUSCULOSKELETAL STIFFNESS (STIFF MUSCLES), CHILLS (CHILLS), PYREXIA (FEVER) and HEADACHE (HEADACHES) in a male patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. Unknown) for COVID-19 vaccination. No Medical History information was reported. On 10-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On an unknown date, the patient experienced PAIN IN EXTREMITY (SORE ARM), MUSCULOSKELETAL STIFFNESS (STIFF MUSCLES), CHILLS (CHILLS), PYREXIA (FEVER) and HEADACHE (HEADACHES). At the time of the report, PAIN IN EXTREMITY (SORE ARM), MUSCULOSKELETAL STIFFNESS (STIFF MUSCLES), CHILLS (CHILLS), PYREXIA (FEVER) and HEADACHE (HEADACHES) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Treatment medications were not provided. No concomitant medications of the patient were reported.

Other Meds:

Current Illness:

ID: 1581272
Sex: M
Age: 70
State: TN

Vax Date: 01/14/2021
Onset Date: 02/07/2021
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: arm wasn't as sore; Second dose given on day 24; fever, temperature didn't get as high; headache; chills; fatigue, tiredness; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE PAIN (arm wasn't as sore), INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (Second dose given on day 24), PYREXIA (fever, temperature didn't get as high), HEADACHE (headache) and CHILLS (chills) in a 70-year-old male 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 COVID-19 (experienced loss of taste, loss of smell and a fever of 100.4) in September 2020. Concomitant products included ACETYLSALICYLIC ACID (ASPIRIN (E.C.)) for an unknown indication. On 14-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 07-Feb-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 07-Feb-2021, the patient experienced INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (Second dose given on day 24). On an unknown date, the patient experienced VACCINATION SITE PAIN (arm wasn't as sore), PYREXIA (fever, temperature didn't get as high), HEADACHE (headache), CHILLS (chills) and FATIGUE (fatigue, tiredness). On 07-Feb-2021, INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (Second dose given on day 24) had resolved. At the time of the report, VACCINATION SITE PAIN (arm wasn't as sore) outcome was unknown and PYREXIA (fever, temperature didn't get as high), HEADACHE (headache), CHILLS (chills) and FATIGUE (fatigue, tiredness) had resolved. Concomitant medication include Blood Pressure Medication and statin medication. No Treatment medication was provided. This case was linked to MOD-2021-022930 (Patient Link). Most recent FOLLOW-UP information incorporated above includes: On 25-May-2021: Follow-up received 25-May-2021 which includes Outcome of the events was updated to recovered On 31-Jul-2021: Follow-up received on 31-jul-2021 in which Reporter Address was added. Medical history, Concomitant medication and new events were added.

Other Meds: ASPIRIN (E.C.)

Current Illness:

ID: 1581273
Sex: F
Age: 78
State: FL

Vax Date: 02/12/2021
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: Nausea

Symptoms: red rash; warm to touch; A spontaneous report was received from a reporter, concerning a female patient of 78-Years - age, who received Moderna's COVID-19 vaccine and experienced red rash, warm to touch. The patient's medical history was not provided. No relevant Concomitant product medication was provided by reporter. On12 -feb-2021 , prior to onset of event patient received their first of two planned doses of mRNA-1273 (lot number 015M20A) via intramuscular for COVID-19 infection prophylaxis. On 22-Feb-2021,the patient experienced red rash, warm to touch . Treatment information was not provided. Action taken with mRNA-1273 in response to the event was unknown. The outcome of the events considered was unknown at the time of this report.

Other Meds:

Current Illness:

ID: 1581274
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: Injection site pain

Symptoms: Bad pain after getting the vaccine; This spontaneous case was reported by an other and describes the occurrence of PAIN (Bad pain after getting the 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. On an unknown date, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On an unknown date, the patient experienced PAIN (Bad pain after getting the vaccine). At the time of the report, PAIN (Bad pain after getting the vaccine) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medications reported. No treatment information provided.

Other Meds:

Current Illness:

ID: 1581275
Sex: M
Age: 76
State: CA

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 induration, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: Immense fatigue; Arm a little sore; listless; Slept a lot; This spontaneous case was reported by a consumer and describes the occurrence of FATIGUE (Immense fatigue), PAIN IN EXTREMITY (Arm a little sore), LISTLESS (listless) and HYPERSOMNIA (Slept a lot) in a 76-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 011M2DA) for COVID-19 vaccination. The patient's past medical history included No adverse event. 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 FATIGUE (Immense fatigue), PAIN IN EXTREMITY (Arm a little sore), LISTLESS (listless) and HYPERSOMNIA (Slept a lot). On 22-Feb-2021, FATIGUE (Immense fatigue), PAIN IN EXTREMITY (Arm a little sore), LISTLESS (listless) and HYPERSOMNIA (Slept a lot) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Treatment included Tylenol and a low dose valium

Other Meds:

Current Illness:

ID: 1581276
Sex: F
Age:
State: CA

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, Dizziness, Nausea, Pain, Tachycardia

Symptoms: Body Aches; Covid; This spontaneous case was reported by a consumer and describes the occurrence of MYALGIA (Body Aches) and COVID-19 (Covid) in a 34-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On an unknown date, the patient experienced MYALGIA (Body Aches) and COVID-19 (Covid). At the time of the report, MYALGIA (Body Aches) and COVID-19 (Covid) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, SARS-CoV-2 test: positive. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Treatment and concomitant medications were not provided by reporter.

Other Meds:

Current Illness:

ID: 1581277
Sex: M
Age: 81
State: NJ

Vax Date: 01/26/2021
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: Tremor

Symptoms: Swollen left arm; sore left arm; veins of the arm looked like sticking out.; pain at the injection site; This spontaneous case was reported by a consumer and describes the occurrence of PERIPHERAL SWELLING (Swollen left arm), PAIN IN EXTREMITY (sore left arm), SUPERFICIAL VEIN PROMINENCE (veins of the arm looked like sticking out.) and VACCINATION SITE PAIN (pain at the injection site) in an 81-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. Concurrent medical conditions included Hypertension, Lactose intolerant and Allergy (liquid soap). On 26-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 27-Jan-2021, the patient experienced PERIPHERAL SWELLING (Swollen left arm), PAIN IN EXTREMITY (sore left arm), SUPERFICIAL VEIN PROMINENCE (veins of the arm looked like sticking out.) and VACCINATION SITE PAIN (pain at the injection site). At the time of the report, PERIPHERAL SWELLING (Swollen left arm), PAIN IN EXTREMITY (sore left arm), SUPERFICIAL VEIN PROMINENCE (veins of the arm looked like sticking out.) and VACCINATION SITE PAIN (pain at 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. Reporter did not allow further contact

Other Meds:

Current Illness: Allergy (liquid soap); Hypertension; Lactose intolerant

ID: 1581278
Sex: M
Age:
State:

Vax Date:
Onset Date: 01/04/2021
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: Caller got the COVID vaccine on 4-Jan-2021 and at the time had I had COVID-19; This spontaneous case was reported by a consumer and describes the occurrence of COVID-19 (Caller got the COVID vaccine on 4-Jan-2021 and at the time had I had COVID-19) in a male patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The patient's past medical history included No adverse event. On 04-Jan-2021, the patient 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 received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) at an unspecified dose. On 04-Jan-2021, the patient experienced COVID-19 (Caller got the COVID vaccine on 4-Jan-2021 and at the time had I had COVID-19). At the time of the report, COVID-19 (Caller got the COVID vaccine on 4-Jan-2021 and at the time had I had COVID-19) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 05-Jan-2021, SARS-CoV-2 test: positive. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown Route) and mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Treatment and concomitant medications were not provided by reporter. Reporter did not allow further contact

Other Meds:

Current Illness:

ID: 1581279
Sex: F
Age:
State: OK

Vax Date: 01/27/2021
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: Injection site erythema, Injection site induration, Injection site pruritus, Injection site swelling, Myalgia

Symptoms: arm started to become red and swollen; arm started to become red and swollen; This spontaneous case was reported by a consumer and describes the occurrence of ERYTHEMA (arm started to become red and swollen) and PERIPHERAL SWELLING (arm started to become red and swollen) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 030120A) for COVID-19 vaccination. No Medical History information was reported. On 27-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 ERYTHEMA (arm started to become red and swollen) and PERIPHERAL SWELLING (arm started to become red and swollen). At the time of the report, ERYTHEMA (arm started to become red and swollen) and PERIPHERAL SWELLING (arm started to become red and swollen) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Treatment and concomitant medications were not provided by reporter. Reporter did not allow further contact

Other Meds:

Current Illness:

ID: 1581280
Sex: F
Age:
State: GA

Vax Date: 01/26/2021
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: Cough, Limb discomfort, Pain, SARS-CoV-2 test positive

Symptoms: swollen face; This spontaneous case was reported by a consumer and describes the occurrence of SWELLING FACE (swollen face) 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 medical history was reported. ). On 26-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 SWELLING FACE (swollen face). At the time of the report, SWELLING FACE (swollen face) outcome was unknown. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Concomitant product use was not provided. Treatment information was not provided.

Other Meds:

Current Illness:

ID: 1581281
Sex: M
Age:
State: GA

Vax Date: 02/22/2021
Onset Date: 02/22/2021
Rec V Date: 08/18/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: very very bad nausea; throwing up all night; A spontaneous report was received from a reporter, concerning a female patient of 40-Years - age, who received Moderna's COVID-19 vaccine and experienced very very bad nausea, throwing up all night. The patient's medical history was not provided. No relevant Concomitant product medication was provided by reporter. On22 -feb-2021 , prior to onset of event patient received their second of two planned doses of mRNA-1273 (lot number unknown) via unknown route for COVID-19 infection prophylaxis. On 22-Feb-2021,the patient experienced a "very very bad nausea" and has been throwing up all night. Treatment information was not provided. Action taken with mRNA-1273 in response to the event was not applicable. The outcome of the events considered was unknown at the time of this report.

Other Meds:

Current Illness:

ID: 1581282
Sex: F
Age: 88
State: MI

Vax Date: 02/18/2021
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 erythema, Injection site pain, Injection site swelling

Symptoms: Pain; Tenderness; Redness; Itchiness; This spontaneous case was reported by a consumer and describes the occurrence of PAIN (Pain), TENDERNESS (Tenderness), ERYTHEMA (Redness) and PRURITUS (Itchiness) in an 88-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 013M20A) for COVID-19 vaccination. The patient's past medical history included COVID-19 in November 2020. On 18-Feb-2021, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 20-Feb-2021, the patient experienced PAIN (Pain), TENDERNESS (Tenderness), ERYTHEMA (Redness) and PRURITUS (Itchiness). The patient was treated with PARACETAMOL (TYLENOL) at an unspecified dose and frequency. At the time of the report, PAIN (Pain), TENDERNESS (Tenderness), ERYTHEMA (Redness) and PRURITUS (Itchiness) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown.

Other Meds:

Current Illness:

ID: 1581283
Sex: F
Age:
State:

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

Symptoms: arm itchy; arm red; severe headache; arm hot; delayed reaction; arm swelled; fogginess; diarrhea; joint swelling; This spontaneous case was reported by a consumer and describes the occurrence of VISION BLURRED (fogginess), SKIN REACTION (delayed reaction), DIARRHOEA (diarrhea), JOINT SWELLING (joint swelling) and PERIPHERAL SWELLING (arm swelled) in a 64-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 013M20A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. The patient's past medical history included Thyroid disorder (.). Concurrent medical conditions included Cancer and Hypertension (Medical history reported as blood pressure.). Concomitant products included ESCITALOPRAM OXALATE (LEXAPRO) for an unknown indication. On 12-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 12-Feb-2021, the patient experienced VISION BLURRED (fogginess), DIARRHOEA (diarrhea) and JOINT SWELLING (joint swelling). On 20-Feb-2021, the patient experienced SKIN REACTION (delayed reaction), PERIPHERAL SWELLING (arm swelled), VACCINATION SITE WARMTH (arm hot) and HEADACHE (severe headache). On an unknown date, the patient experienced VACCINATION SITE REACTION (arm itchy) and VACCINATION SITE ERYTHEMA (arm red). The patient was treated with PARACETAMOL (TYLENOL) for Symptomatic treatment, at an unspecified dose and frequency. On 14-Feb-2021, VISION BLURRED (fogginess), DIARRHOEA (diarrhea) and JOINT SWELLING (joint swelling) had resolved. At the time of the report, SKIN REACTION (delayed reaction), PERIPHERAL SWELLING (arm swelled), VACCINATION SITE REACTION (arm itchy), VACCINATION SITE WARMTH (arm hot), VACCINATION SITE ERYTHEMA (arm red) and HEADACHE (severe headache) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Concomitant medications High blood pressure medication, thyroid medication, water pill.

Other Meds: LEXAPRO

Current Illness: Cancer; Hypertension (Medical history reported as blood pressure.)

ID: 1581284
Sex: F
Age: 72
State: CT

Vax Date: 02/14/2021
Onset Date: 02/21/2021
Rec V Date: 08/18/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Pain in extremity

Symptoms: a reaction in the injection site/ is very itchy; A spontaneous report was received from a consumer/physician concerning a 72 years old, female patient who developed/experienced a reaction in the injection site, very itchy , no rash, no red. The patient's medical history was not provided.Concomitant product use was not provided/unknown by the reporter. On 14FEB-2021 ,prior to the onset of the symptoms, the patient received their first of two planned doses of mRNA-1273 (Batch number:[016M20A] intramuscularly in the upper left arm for prophylaxis of COVID-19 infection. On 21-FEB-2021 ,the patient experienced events a reaction in the injection site ,very itchy, no red ,no rash. Treatment details include hydrochloride and a cortisone cream. Action taken with mRNA in response to events was not reported. On an unknown date ,the outcome of events a reaction at the injection site ,very itchy ,no pain ,no rash was unknown.

Other Meds:

Current Illness:

ID: 1581285
Sex: F
Age: 65
State: GA

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

Symptoms: arm was a little bit sore; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (arm was a little bit sore) in a 65-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 026L20A) for COVID-19 vaccination. No Medical History information was reported. On 21-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 21-Jan-2021, the patient experienced PAIN IN EXTREMITY (arm was a little bit sore). At the time of the report, PAIN IN EXTREMITY (arm was a little bit sore) outcome was unknown. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant medications reported by investigator Patient put rubbing alcohol on a white tissue and applied it to the area is the treatment medication reported. This case was linked to MOD-2021-021923 (Patient Link).

Other Meds:

Current Illness:

ID: 1581286
Sex: U
Age:
State: LA

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

Symptoms: experiencing redness, swelling and tingling in the right side of the face; experiencing redness, swelling and tingling in the right side of the face; tingling in the right side of the face; This spontaneous case was reported by a health care professional and describes the occurrence of SWELLING (experiencing redness, swelling and tingling in the right side of the face), ERYTHEMA (experiencing redness, swelling and tingling in the right side of the face) and PARAESTHESIA (tingling in the right side of the face) 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 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 SWELLING (experiencing redness, swelling and tingling in the right side of the face), ERYTHEMA (experiencing redness, swelling and tingling in the right side of the face) and PARAESTHESIA (tingling in the right side of the face). At the time of the report, SWELLING (experiencing redness, swelling and tingling in the right side of the face), ERYTHEMA (experiencing redness, swelling and tingling in the right side of the face) and PARAESTHESIA (tingling in the right side of the face) 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: 1581287
Sex: F
Age: 65
State: GA

Vax Date: 01/21/2021
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: Hypotonia, Lethargy, Respiratory rate decreased, Screaming, Skin warm

Symptoms: itch near the injection site; hardness near the injection site; pain near injection site; swelling near the injection site; red near the injection site; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE PRURITUS (itch near the injection site), VACCINATION SITE INDURATION (hardness near the injection site), VACCINATION SITE PAIN (pain near injection site), VACCINATION SITE SWELLING (swelling near the injection site) and VACCINATION SITE ERYTHEMA (red near the injection site) in a 65-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 026L20A and 023M20A) for COVID-19 vaccination. No Medical History information was reported. On 21-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 18-Feb-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 18-Feb-2021, the patient experienced VACCINATION SITE PRURITUS (itch near the injection site), VACCINATION SITE INDURATION (hardness near the injection site), VACCINATION SITE PAIN (pain near injection site), VACCINATION SITE SWELLING (swelling near the injection site) and VACCINATION SITE ERYTHEMA (red near the injection site). On 22-Feb-2021, VACCINATION SITE PRURITUS (itch near the injection site), VACCINATION SITE INDURATION (hardness near the injection site) and VACCINATION SITE PAIN (pain near injection site) had resolved. At the time of the report, VACCINATION SITE SWELLING (swelling near the injection site) had not resolved and VACCINATION SITE ERYTHEMA (red near the injection site) outcome was unknown. Action taken with mRNA-1273 in response to the events was not Applicable. No concomitant medications reported by investigator Patient put rubbing alcohol on a white tissue and applied it to the area is the treatment medication reported. This case was linked to MOD-2021-021920 (Patient Link).

Other Meds:

Current Illness:

ID: 1581288
Sex: F
Age:
State: LA

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: Vomiting

Symptoms: radiating in the top of her arm to her hand; pain at the injection arm where the vaccine was applied (R arm); This spontaneous case was reported by a nurse and describes the occurrence of PAIN IN EXTREMITY (radiating in the top of her arm to her hand) and INJECTION SITE PAIN (pain at the injection arm where the vaccine was applied (R arm)) in a 42-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 an unknown date, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On an unknown date, the patient experienced PAIN IN EXTREMITY (radiating in the top of her arm to her hand) and INJECTION SITE PAIN (pain at the injection arm where the vaccine was applied (R arm)). At the time of the report, PAIN IN EXTREMITY (radiating in the top of her arm to her hand) and INJECTION SITE PAIN (pain at the injection arm where the vaccine was applied (R 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. Treatment for the event included an injection to treat the pain as per advice of her doctor and also taking some medicines like paracetamol.

Other Meds:

Current Illness:

ID: 1581289
Sex: F
Age:
State: FL

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

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

Lab Data:

Allergies:

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: sinus infection; This spontaneous case was reported by a consumer and describes the occurrence of SINUSITIS (sinus infection) in a 66-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 029L20A) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 16-Feb-2021, the patient experienced SINUSITIS (sinus infection). At the time of the report, SINUSITIS (sinus infection) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant drugs are not provided. No treatment. Reporter did not allow further contact

Other Meds:

Current Illness:

ID: 1581290
Sex: F
Age: 66
State: MI

Vax Date: 02/17/2021
Onset Date:
Rec V Date: 08/18/2021
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Symptom List: Back pain, Cold sweat, Headache, Nausea, Vomiting

Symptoms: dot spot on back arm, another dark spot where I bend my arm; pain; scar above my elbow; This spontaneous case was reported by a consumer and describes the occurrence of RASH MACULAR (dot spot on back arm, another dark spot where I bend my arm), MYALGIA (pain) and SCAR (scar above my elbow) in a 66-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 023M20A) for COVID-19 vaccination. Concurrent medical conditions included Drug allergy (allergic to sulfa drug) and Drug allergy (allergic to pneumovax vaccine). On 17-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 RASH MACULAR (dot spot on back arm, another dark spot where I bend my arm), MYALGIA (pain) and SCAR (scar above my elbow). At the time of the report, RASH MACULAR (dot spot on back arm, another dark spot where I bend my arm), MYALGIA (pain) and SCAR (scar above my elbow) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No relevant Concomitant product medication was provided by reporter. Treatment for the event included paracetmol. Most recent FOLLOW-UP information incorporated above includes: On 04-Mar-2021: No specific follow-up information recorded.

Other Meds:

Current Illness: Drug allergy (allergic to sulfa drug); Drug allergy (allergic to pneumovax vaccine)

ID: 1581291
Sex: F
Age: 69
State:

Vax Date: 02/16/2021
Onset Date: 02/17/2021
Rec V Date: 08/18/2021
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Symptom List: Injection site swelling, Limb discomfort

Symptoms: Tested positive for Covid-19; A spontaneous report was received from a consumer concerning a 70-year-old, female patient, who received Moderna's COVID-19 vaccine (mRNA-1273) and was tested positive for Covid-19. The patient's medical history, as provided by the reporter, included thyroid. Concomitant medication included thyroid for product use of unknown indication. On 16 Feb 2021, approximately one day prior to the onset of the events, the patient received their first of two planned doses of mRNA-1273 (Batch number: 011l20a) intramuscularly for prophylaxis of COVID-19 infection. On 17 Feb 2021, the patient was tested positive for Covid-19. Lab test included SARS Cov-1 test. Treatment information was not provided. Action taken with mRNA-1273 in response to the events was not reported. The outcome of the event tested positive for Covid-19 was unknown.

Other Meds: THYROID

Current Illness: Thyroid disorder NOS (Thyroid was reported.)

ID: 1581292
Sex: M
Age:
State: FL

Vax Date: 01/27/2021
Onset Date:
Rec V Date: 08/18/2021
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Symptom List: Chills, Diarrhoea, Fatigue, Feeling abnormal, Headache

Symptoms: Rash on my back and my stomach; This spontaneous case was reported by a consumer and describes the occurrence of rash 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 27-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 RASH (Rash on my back and on my stomach). At the time of the report, RASH (Rash on my back and on my stomach) was resolving. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown.

Other Meds:

Current Illness:

ID: 1581293
Sex: F
Age:
State: OK

Vax Date: 02/22/2021
Onset Date: 02/23/2021
Rec V Date: 08/18/2021
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Symptom List: Hot flush, Myalgia, Nausea, Tension headache

Symptoms: Pain; Did not have strength to get up; This spontaneous case was reported by a consumer and describes the occurrence of PAIN (Pain) and ASTHENIA (Did not have strength to get up) in an 86-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 22-Feb-2021, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 23-Feb-2021, the patient experienced PAIN (Pain) and ASTHENIA (Did not have strength to get up). At the time of the report, PAIN (Pain) and ASTHENIA (Did not have strength to get up) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medications reported. No treatment medications provided by the reporter.

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 704,237

Page last modified: 26 October 2021 2:21am