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From the 11/26/2021 release of VAERS data:

Found 344,599 cases where Vaccine targets COVID-19 (COVID19) and Manufacturer is MODERNA

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Case Details

This is page 14 out of 34,460

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VAERS ID: 908031 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: New Mexico  
Vaccinated:2020-12-23
Onset:2020-12-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2020-12-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 039K20 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Pruritus, 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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: asthma
Allergies: Penicillin, honeydew melon
Diagnostic Lab Data:
CDC Split Type:

Write-up: hives, pruritus within 30 minutes


VAERS ID: 908035 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2020-12-22
Onset:2020-12-23
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2020-12-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood glucose increased, Blood urea normal, Chills, Full blood count, Influenza A virus test negative, Influenza B virus test, Lymphocyte count decreased, Mean cell haemoglobin, Metabolic function test, Neutrophil count increased, Respiratory syncytial virus test negative, SARS-CoV-2 test negative, Vomiting, White blood cell count increased
SMQs:, Acute pancreatitis (broad), Haematopoietic leukopenia (narrow), Hyperglycaemia/new onset diabetes mellitus (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions: PMH included asthma
Allergies: Percocet, sulfa
Diagnostic Lab Data: CMP - lab values WNL with exception of glucose 115 mg/dL and BUN 18 mg/dL. CBC - WBC 13.7, MCH 32.5, seg neutrophils 75%, lymphocytes 5%, COVID-19/Influenza A/B/RSV PCRs negative.
CDC Split Type:

Write-up: Patient presented to ED 1 day after administration of COVID-19 vaccine. She had rigors and chills the day before and day of ED presentation. Denies having a fever prior to ED presentation but did note general body aches and nausea. Patient also had 1 episode of vomiting on 12/22. Patient''s vital signs were BP 145/109, HR 75, RR 20, O2 sat 96, temp 98.7F. Receive IV bolus of NaCL 0.9% 1,000 mL in ED in addition to ketorolac 15 mg, and ondansetron 4 mg. Patient was discharged home from the ED.


VAERS ID: 908044 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Michigan  
Vaccinated:2020-12-23
Onset:2020-12-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2020-12-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Obstructive airways disorder, Oral pruritus, Respiratory distress
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Asthma/bronchospasm (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Respiratory failure (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? Yes
Hospitalized? No
Previous Vaccinations: HEP A
Other Medications: UNKNOWN
Current Illness: COVID + 12/8/20
Preexisting Conditions: UNKNOWN
Allergies: YES (HEP A VACCINE, TREE NUTS)
Diagnostic Lab Data:
CDC Split Type:

Write-up: PT WAS ADMINISTERED MODERNA VACCINE AT HD ON 12/23 AROUND 1540. PT HAS EXTENSIVE HISTORY OF ALLERGIC REACTIONS (HEP A VACCINE AND TREE NUTS). PT ALSO COVID + ON 12/8/20 . HX REVIEWED WITH HD RN PRIOR TO ADMINISTERING. PT WAS ADVISED TO WAIT 30 MIN IN WAITING ROOM. EMS STAFF ON SITE FOR CLINIC. PT STARTED COMPLAINING OF "ITCHY MOUTH" AROUND 1620 AT WHICH POINT EMS ATTEMPTED TO ESCORT PT TO PERSONAL VEHICLE TO DRIVE HER TO LOCAL ED. PT MADE IT TO THE THE VEHICLE BUT DEVELOPED INCREASED RESPIRATORY DISTRESS AND AIRWAY RESTRICTION. AMBULANCE WAS CALLED. EMS ADMISNTERED .3ML EPI AT 1631 AND APPLIED 8L O2 VIA MASK. ABUMBULACE ARRIVED AT 1636. PT TAKEN TO LOCAL ED VIA AMBULANCE


VAERS ID: 908050 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Female  
Location: Missouri  
Vaccinated:2020-12-22
Onset:2020-12-22
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2020-12-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011J20A / 1 AR / IM

Administered by: Work       Purchased by: ?
Symptoms: Injection site reaction, Rash, Rash erythematous, Rash papular
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: none
CDC Split Type:

Write-up: localized raised red rash at injection site - given diphenhydramine 25 mg PO x1 - increased monitoring for 30 minutes. Patient still had rash but it was improved. Was able to leave clinic to home


VAERS ID: 908054 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Missouri  
Vaccinated:2020-12-21
Onset:2020-12-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2020-12-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011J20A / 1 RA / IM

Administered by: Work       Purchased by: ?
Symptoms: Abdominal discomfort, Blood pressure increased, Feeding disorder, Headache, Hyperhidrosis, Injection site pain, Lymphadenopathy, Pain in extremity, Skin tightness, Sleep disorder, Tachycardia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypertension (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: The evening after she received the vaccine, she had a HA and stomach distress. She reports waking up frequently due to sweating. On 12/22/20, her symptoms continued and got a bit worse - including soreness at the injection site with continued stomach distress and HA. She took ibuprofen 400 mg PO TID. Was unable to eat food, only drank Sprite. During the early morning hours of 12/23, was unable to sleep due to severe pain in right upper arm. She felt a "pulling sensation" and felt an enlarged lymph node under her arm. It was very "tight" - she was able to come to work - sent to the ED for evaluation - found to have BP slightly above her normal range, mild tachycardia. Was released and told to continue symptomatic treatment and to call or come in if symptoms worsened.


VAERS ID: 908055 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Nebraska  
Vaccinated:2020-12-21
Onset:2020-12-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2020-12-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011J20A / 5 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Chills, Nausea, Tremor, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), 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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Approximately three hours after receiving the vaccine I was violently puking and nauseous. I never had a fever, but I had uncontrollable shaking and chills.


VAERS ID: 908062 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Nebraska  
Vaccinated:2020-12-23
Onset:2020-12-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2020-12-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011J20A / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Haemoglobin normal, Hypersensitivity, Rash, Red blood cell count normal, Throat tightness, White blood cell count normal
SMQs:, Anaphylactic reaction (narrow), Angioedema (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Results Units Reference Range White Blood Cell Count 9.01 10*3/uL 3.80-10.80 (10*3/uL) Red Blood Cell Count 4.58 10*6/uL 3.93-6.00 (10*6/uL) Hemoglobin 13.8 g/dL 12.0-18.0 (g/dL
CDC Split Type:

Write-up: Age: 43 years 12/23/2020 12:21 Chief Complaint: ALLERGIC REACTION History of Presenting Illness: This 43 yo female presents from specialty clinic for an allergic reaction. Patient has just received the Moderna Sars-Cov2 vaccine. She has had covid in the past, and her Igg tested outpatient was positive at 5.2 (per patient). She had received the vaccine at 11, and says that she usually has a reaction to vaccinations and drugs. She began having some rash around the neck and felt like her throat was closing. She was brought to the emergency room.


VAERS ID: 908071 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Missouri  
Vaccinated:2020-12-23
Onset:2020-12-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2020-12-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011J20A / 1 AR / IM

Administered by: Private       Purchased by: ?
Symptoms: Anxiety, Chills, Dizziness, Dyspnoea, Nausea, Paraesthesia, Rash, Tremor
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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

Write-up: hand shaking, chills, rash, nausea, lightheadedness ? reports hard to take a deep breath, given diphenhydramine 50 mg PO x 1 @ 10:15 in clinic and an additional 25 mg PO x 1 @ 10:30 in the clinic. Symptoms persisted - pt anxious - taken to ED for evaluation. After 10-15 minutes in ED, her symptoms subsided ? she only had mild tingling in the left hand along with two red spots on the back of her neck. Given prednisone 50 mg PO x 1 in ED. observed in ED for 2 hours ? pt feels much better ? pt felt comfortable going home ? told to continue to take Benadryl and prednisone for next 3 days. Instructions given to return to ED for any worsening of symptoms. Rx with Prednisone 50 mg daily x 3


VAERS ID: 908078 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Male  
Location: Alaska  
Vaccinated:2020-12-21
Onset:2020-12-22
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2020-12-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011J20A / 1 LA / IM

Administered by: Military       Purchased by: ?
Symptoms: Chills, Diarrhoea, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: Keflex-Swelling of the face and throat
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient developed diarrhea, chills and a measured fever 100.4 24 hours after receiving the vaccine.


VAERS ID: 908103 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Iowa  
Vaccinated:2020-12-23
Onset:2020-12-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2020-12-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Erythema, Fatigue, Nausea, Pain, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (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: Localized pain, redness
Other Medications: Levothyroxine 125.Mcg daily Aleve 220 mg Bid Multivitamin with zinc daily Tramadol 50 mg Tid Fish oil 2000 mg daily Famotidine 20 mg Bid Lisinopril 20 mg daily Atorvastatin 20 mg daily
Current Illness: Covid + 11/15/20-hospitalized d/t dehydration and covid pneumonia
Preexisting Conditions: Graves disease Hypertension Hyperlipidemia Spondylitis with chronic back pain Gerd q
Allergies: Amoxicillin- hives
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Nausea Vomiting Fatigue


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