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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 15 out of 34,460

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VAERS ID: 908119 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Male  
Location: Missouri  
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 039K20-2A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Mental status changes, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (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: Tylenol, Atorvastatin, Bisacodyl, Calcium Acetate, Clopidogrel Bisulfate, diphenhydramine, Docusate, Levothyroxine, Midodrine, Morphine Sulfate, Oxycodone, Omeprazole, Pregabalin, Salicyic Acid gel, Senna, Simethicone, Vitamin B, Vitamin D,
Current Illness: Polyneuropathy, Sleep Apnea, Reflux, End Stage Renal disease, Anemia, Thrombocytopenia, Hypothyroidism, Type 2 Diabetes, Hyperlipidemia, Retinopathy, Hypotension, Cellulitis, Peripheral Vascular Disease, Acquired absence of kidney, Dependence on renal dialysis, Acquired absence of leg below knee. Recent mrsa infected wound, finished vancomycin on 12/18
Preexisting Conditions: See above.
Allergies: None
Diagnostic Lab Data: Started on Vancomycin in case it''s related to infected wound which is a reoccurring problem with this individual. Also started on Phenergan.
CDC Split Type:

Write-up: Fever 101.8, vomiting, mental status change


VAERS ID: 908120 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Male  
Location: New York  
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 039K20A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Electrocardiogram, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (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: Thyroid disease - Hypothyroid
Allergies: None
Diagnostic Lab Data: 12/23/2020: ekg
CDC Split Type:

Write-up: Syncopal episode after receiving vaccine


VAERS ID: 908123 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Male  
Location: New York  
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 039K20A / 1 UN / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood pressure immeasurable, Heart rate decreased, Hyperhidrosis, Nausea, Pulse abnormal, Pulse absent, Retching
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (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: Levothyroxine, Tums
Current Illness: hx multiple vasovagal syncope
Preexisting Conditions:
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient became diaphoretic and nauseated about 10 minutes post vaccination with Moderna Covid-19 vaccine. Patient was assisted to stretcher who he had dry heaves and stated he felt nauseated. HR was low around 38 and we were unable to determine a B/P but patient had a very weak radial pulse which at times was unable to be felt at all (due to low B/P). Decision made to transport patient to the ED for further evaluation. Patient eventually discharged from emergency department.


VAERS ID: 908125 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: California  
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 02SJ20-2A / 1 RA / -

Administered by: Private       Purchased by: ?
Symptoms: Blood glucose normal, Electrocardiogram normal, Heart rate increased, Paraesthesia oral
SMQs:, Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Dehydration (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: Denies
Current Illness: Denies
Preexisting Conditions: S/P gastric bypass
Allergies: Denies
Diagnostic Lab Data: EKG; normal, rate 81, no arrythmias, normal intervals Glucose 105 500ml NS Bolus Observed and discharged without further issue
CDC Split Type:

Write-up: 30 mins after vaccination Felt rapid heart rate, tingling in lips, initial BP 100/60


VAERS ID: 908140 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Florida  
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 025J20A / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Dizziness
SMQs:, Anticholinergic syndrome (broad), Vestibular 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: Cymzia Lisinopril Methotrexate Ibuprofen 800 Folic Acid
Current Illness:
Preexisting Conditions: Ankylosing Spondylitis
Allergies: Orange Juice, Scallops
Diagnostic Lab Data: n/a
CDC Split Type:

Write-up: Felt lightheaded since the vaccine


VAERS ID: 908164 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
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: Arthralgia, Fatigue, Headache, Injection site erythema, Injection site mass, Injection site warmth, Myalgia, Pain in extremity
SMQs:, Rhabdomyolysis/myopathy (broad), Extravasation events (injections, infusions and implants) (broad), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (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: Vitmain D3, Calcium, Magnesium
Current Illness: none
Preexisting Conditions: Pleuritis? Some recurring chest pain but I never got a definitive diagnosis of cause.
Allergies: Zithromax, Tobramycin, Neosporin, Sulfa, Amoxicyllin, Rifampin, Isoniazid
Diagnostic Lab Data:
CDC Split Type:

Write-up: Woke up with just a sore arm the following day. As time progressed my arm got more sore; the site was hot, with a red circle and lump under the skin. Headache, muscle and joint aches, fatigue. Treated with some Nyquil, Excedrin, and sleep. Onset was about 16 hours after the original dose. almost 2 days later I''m still very fatigued, although the rest of the pain has largely gone away.


VAERS ID: 908175 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Florida  
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 039K20A / 1 LA / IM

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

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: Multi vitamin
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Headache, redness below injection site, mild swelling


VAERS ID: 908181 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Male  
Location: New York  
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 011J20A / UNK LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chills, Fatigue, Pain in extremity, Pyrexia, Tremor
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Tendinopathies and ligament disorders (broad), 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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No
Current Illness: No
Preexisting Conditions: Intermittent asthma not requiring inhaler for years
Allergies: No
Diagnostic Lab Data: No
CDC Split Type:

Write-up: Fever of 39. Chills shakiness severe fatigue Arm soreness


VAERS ID: 908184 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Unknown  
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 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Anxiety, Headache, Hypertension
SMQs:, Neuroleptic malignant syndrome (broad), Hypertension (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt. c/o moderate anxiety during vaccine. Around 15 mons after the vaccine , she c/o mild headache and stated she has history of HTN. She was hypertensive and her pulse was WNL. She was rechecked in 15 mins and her BP decreased and HR stable with continued headache. The patient denied any other symptoms and declined going to the ED. She left without further complaints 45 mins after her vaccine.


VAERS ID: 908187 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Male  
Location: Unknown  
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 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Anxiety, Tachycardia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Hypoglycaemia (broad), Dehydration (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:
CDC Split Type:

Write-up: Pt c/o tachycardia and maybe anxiety. Pt is an MD. Tachycardia at 15 mins post vaccine- radial pulse 132 and BP 150/90. Denied other symptoms. Rechecked in 15 mins and HR 84-91 and BP 154/95. Continued to deny any other symptoms to include CP or SOB. No change in mental status. Declined treatment in ED. Kept and monitored for 15 more mins. and left 45 mins post vaccine. Continued to state maybe he was anxious


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