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From the 10/15/2021 release of VAERS data:

Found 85,643 cases where Vaccine is COVID19 and Manufacturer is MODERNA and Standard-MedDRA-Query broadly-matches 'Anaphylactic reaction'



Case Details

This is page 12 out of 8,565

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VAERS ID: 909034 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Maine  
Vaccinated:2020-12-23
Onset:2020-12-24
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2020-12-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011J20A / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Injection site pain, Pain, Pain in extremity, Paraesthesia, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Citalopram 20mg daily, multivitamin, probiotic, melatonin 3mg
Current Illness: None
Preexisting Conditions: Migraines w/aura, depression
Allergies: Penicillin
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Initially no pain, then moderate-severe pain at injection site that radiated down towards my fingertips. This started approximately an hour after receiving the vaccine. Tingling in both hands and forearms, which began shortly after midnight. Today (12/24) I have mild swelling, as well as the same pain and tingling.


VAERS ID: 909946 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2020-12-23
Onset:2020-12-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2020-12-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011J20A / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Anxiety, Flushing, Paraesthesia, Throat irritation, Throat tightness, Tremor
SMQs:, Anaphylactic reaction (narrow), Angioedema (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Hypersensitivity (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: Nkda
Diagnostic Lab Data: none
CDC Split Type:

Write-up: pt received a COVID vaccine of moderna and within 15 minutes pt c/o throat feellng itchy and tight down low. Also, c/o of tingling in fingers and toes. Pt noticeably shaking. Pt has a hx of fainting with needles. Pt become more anxious and requested and ambulance to be called. Color was flushed. B/P 169/99 P146 SPO2 99%. For pts comfort gave O2 at 2L/min via NC. Pt remained alert and oriented and talking. EMT administered Benadryl 50mg IM. Ambulance escorted pt to ER where only observation was done. F/U with pt about 2 hours later. Pt states she believes she panicked and was doing fine right now. No other issues.


VAERS ID: 909952 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2020-12-23
Onset:2020-12-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2020-12-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011J20A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Dyspnoea, Electrocardiogram abnormal, Feeling abnormal, Nausea, Paraesthesia oral, Throat tightness
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypersensitivity (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Singular, Breo, Ventolin Inhaler, Albuterol nebs, ambien
Current Illness: none
Preexisting Conditions: arthritis, kidney stones, asthma
Allergies: nuts, pcn,codiene
Diagnostic Lab Data: EKG No labs
CDC Split Type:

Write-up: approx. one hour after receiving vaccine pt started having throat tightness, nausea, lips tingling, SOB and "feeling weird". States has had anaphylaxis in the past from nuts and uses an EPI pen. States she used her pen but did not get relief so went to ER where she received IV benadryl, tagment and steroids. EKG was abnormal. States no problems at injection site. F/U with patient appox. 7 hours after incident and pt states she is doing fine and not having any issues now.


VAERS ID: 909039 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: New York  
Vaccinated:2020-12-22
Onset:2020-12-22
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2020-12-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011J20A / 1 RA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Arthralgia, Erythema, Pain, Pain in extremity, Skin warm, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Pertussis vaccine as a baby, stopped breathing.
Other Medications: Wellbutrin 200mg Zoloft 100mg
Current Illness: none
Preexisting Conditions: Had Covid in March, long-standing depression, anxiety, and ADHD.
Allergies: Eggplant The pertussis vaccine
Diagnostic Lab Data:
CDC Split Type:

Write-up: Lots of physical pain and soreness, red and visibly swollen, hot to touch, pain in limbs and joints continuing for 2 days and counting.


VAERS ID: 909041 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Colorado  
Vaccinated:2020-12-23
Onset:2020-12-24
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2020-12-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025J20-02 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chest discomfort, Chills, Fatigue, Feeling of body temperature change, Pain in extremity, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Wellbutrin, albuterol, Ativan, Mirapex.
Current Illness: none
Preexisting Conditions: anxiety, restless leg
Allergies: none
Diagnostic Lab Data: none
CDC Split Type:

Write-up: patient has had hot and cold feelings on her body, feels like her chest is heavy, denies short of breath or difficulty. fever, chills, fatigue, arm soreness.


VAERS ID: 909052 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Florida  
Vaccinated:2020-12-24
Onset:2020-12-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2020-12-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011J20A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Dizziness, Dyspnoea, Feeling hot, Nausea, Pyrexia, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin C, Vitamin D3, Mag-oxide, Potassium Chloride, B12, Calcium, MVI, Wellbutrin, and Topramax
Current Illness: None. Covid + 10/10/2020
Preexisting Conditions: None
Allergies: PCN
Diagnostic Lab Data: None
CDC Split Type:

Write-up: About 0400 hours became extremely hot, dizzy, and nauseated. Threw up and then became short-of-breath. Felt hot and fever went up to 102.6 (oral). Charge nurse was notified and the house supervisor. Was sent home and told to fill out this form.


VAERS ID: 909061 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: Ohio  
Vaccinated:2020-12-24
Onset:2020-12-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2020-12-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA G39K20-2A / 1 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood pressure increased, Swollen tongue
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypertension (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Lipitor, Maxide-25, Cymbalta, ASA
Current Illness:
Preexisting Conditions: hypertension
Allergies: Codeine, PCN, Promethazine, sulfa antibiotics
Diagnostic Lab Data:
CDC Split Type:

Write-up: Reported sensation of tongue swelling during post-vaccination observation at 10 minutes. Epinephrine was refused and she was taken to ED for observation where she was given oral dose of Benadryl and Pepcid. Discharged with instructions to return PRN and follow up with PCP. Elevated BP noted.


VAERS ID: 909065 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Male  
Location: Florida  
Vaccinated:2020-12-22
Onset:2020-12-23
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2020-12-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Flushing, Headache, Injection site pain, Injection site swelling
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: CoQ10 200mg qDay Max Oxide 500mg QHS Riboflavin 400mg qDay B12 sublingual 1000mcg qDay
Current Illness: none
Preexisting Conditions: none
Allergies: Bactrim
Diagnostic Lab Data: none
CDC Split Type:

Write-up: R arm pain and swelling at injection site starting about 24 hours after injection, still present 48 hours after injection Flushed feeling in face with headache starting about 33 hours after injection, lasting approximately 6 hours


VAERS ID: 909073 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Ohio  
Vaccinated:2020-12-23
Onset:2020-12-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2020-12-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011J20A / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Erythema, Hot flush, Skin warm, Swelling, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Crestor, pioglitisone, prozak, metformin, mature multivitamin, flaxseed oil, calcium/magnesium/zinc, vit D & E
Current Illness:
Preexisting Conditions: asthma, hyperlipidemia, type 2 diabetes
Allergies: cephalosporin, latex
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: 10 min after injection hot flash, 1 hour p injection quarter size red welt, raised and hot to touch 24 hrs p injection dollar size red welt, raised size of goose egg and hot to touch. Also, all joints ache. 48 hrs p injection same as above 24 hrs


VAERS ID: 909074 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Ohio  
Vaccinated:2020-12-24
Onset:2020-12-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2020-12-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Metformin Motrin Lisinopril
Current Illness: None
Preexisting Conditions: Diabetes
Allergies: PCN=rash Doxycycline=hives
Diagnostic Lab Data:
CDC Split Type:

Write-up: Hives


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