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

Found 84,128 cases where Location is U.S., Territories, or Unknown and Vaccine is COVID19 and Manufacturer is MODERNA and Standard-MedDRA-Query broadly-matches 'Anaphylactic reaction'

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Case Details

This is page 17 out of 8,413

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VAERS ID: 909482 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: California  
Vaccinated:2020-12-22
Onset:2020-12-23
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2020-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011J02A / UNK UN / IM

Administered by: Private       Purchased by: ?
Symptoms: Anxiety, Chills, Cough, Dizziness, Fatigue, Headache, Nasal congestion, Pain
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Vestibular disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: tylenol, ibuprofen, mucinex, nyquil
Current Illness: 12/2 tested positive for COVID 19
Preexisting Conditions: none
Allergies: nkda
Diagnostic Lab Data: none
CDC Split Type:

Write-up: 12/23 report feeling lightheaded, anxious, body aches, fatigue, headaches, chills without fever, dry cough and nasal congestion


VAERS ID: 909488 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2020-12-24
Onset:2020-12-26
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2020-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Heart rate increased, Hyperventilation, Mental impairment, Pain in extremity
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Dehydration (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: Soreness at site of injection
Other Medications: Daily vitamin, msm capsules 2 a day, wellness capsules 3 a day
Current Illness:
Preexisting Conditions: Pre diabetic this is recent.
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Aching arm, loss of train of thought, deeper breathing, steady increase in heart rate with the occasional drop in heart rate.


VAERS ID: 909496 (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: 2020-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Blister, Burning sensation, Ear pain, Lymphadenopathy, Paraesthesia, Rash, Varicella zoster virus infection
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Opportunistic infections (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: mvi, omega 3
Current Illness: none
Preexisting Conditions: none
Allergies: vibramycin
Diagnostic Lab Data: started on Valtrex 12/26 pm, f/u with optho this week
CDC Split Type:

Write-up: 24 hrs- lymphadenopathy, submandibular, ear pain 36 hrs- primary outbreak of VZV- trigeminal n involvement- tingling/burning 48 hrs- rash and vesicles in trigeminal n distribution


VAERS ID: 909510 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2020-12-26
Onset:2020-12-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2020-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011J20A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Feeling hot, Flushing, Hyperhidrosis, Paraesthesia oral
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (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:
Current Illness: None
Preexisting Conditions: None
Allergies: Latex Sulfa
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient received Moderna COVID-19 vaccine IM in the Administration clinic. During the observation period, patient reported feeling flushed, warm, sweaty, with lip tingling. Vital signs 138/95, HR98, 02 Sat 98%. Proceed out call. Patient transported via wheelchair to ED for further monitoring. In ED, monitored with resolution of tingling of the lips, cheeks still with slight flushing to them. No sob or abd pain or tongue/lip swelling, no worsening rash. Encouraged followup with working well clinic. Patient was discharged home 4 hours later.


VAERS ID: 909512 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2020-12-26
Onset:2020-12-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2020-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025J20A / 1 LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Erythema, Headache, Musculoskeletal chest pain, Sensation of foreign body
SMQs:, Anaphylactic reaction (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: Flu shot- feels heaviness to chest area, lump on throat, rash on chest, takes Benadryl and feels better
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: Tree nuts, tree fruits except citrus, peanuts
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient reported having reaction to flu shot in past so was being monitored closer. Upon her completion of 30 min observation, patient felt lump on throat, slight pain to touch on upper chest, slight headache, some redness to chest area and arms. Patient came prepared and took 25mg of chewable Benadryl at 10:13am, two minutes after symptoms began. 20 minutes later lump on throat was gone and redness to skin had disappeared. Symptoms resolved, patient was monitored for an extra 15min, asymptomatic upon leaving, had husband waiting outside to drive her home. Patient has EpiPen and understands if any sx return, chest pain, trouble breathing, should go to ED.


VAERS ID: 909522 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2020-12-26
Onset:2020-12-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2020-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011J20A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Condition aggravated, Dizziness, Hypoaesthesia oral, Injected limb mobility decreased, Injection site pain, Limb discomfort, Loss of personal independence in daily activities, Migraine, Oropharyngeal discomfort, Pain, Paraesthesia oral, Pruritus, Tongue pruritus
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Dementia (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Vestibular disorders (broad), 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: 10/2006 (age 22) & 04/2016 (age 32) vaccine dtap - severe side effects post vaccine x 1 week: sore throat, cold, severe headache
Other Medications: Centrum women?s multivitamin, vitamin D3 1,000 units, super B complex vitamin, excederin migraine as needed
Current Illness: None
Preexisting Conditions: Migraines
Allergies: Shellfish (allergic reaction), dtap vaccine - severe side effects 2006 & 2016
Diagnostic Lab Data:
CDC Split Type:

Write-up: Saturday 12/26/2020 received Moderna vaccine dose #1 of 2 at 12:00pm. 15 minute observation required (no symptoms) was able to leave. At 12:30 pm - 30 minutes post vaccine: experienced lip & tongue tingling & numbness, throat felt weird. Jaw line became itchy. Self-resolved 15-20 minutes after. At 2:00pm experienced severe migraine & lightheadedness - unable to perform daily routine due to pain & feeling of passing out. At 3:15 pm tongue became itchy & throat feeling weird again. Self-resolved 15 minutes later. Today 12/27/2020 only symptom is severe pain in left upper arm (where injection was) feels like solid mass & difficulty raising arm due to pain & tight feeling (this is very different than just having sore arm post flu vaccine). Pain in arm constant throbbing heavy pain.


VAERS ID: 909528 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Washington  
Vaccinated:2020-12-24
Onset:2020-12-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2020-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037K20A / 7+ LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Arthritis, Fatigue, Pruritus, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Systemic lupus erythematosus (broad), Hypersensitivity (narrow), Arthritis (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune 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: None
Current Illness: None
Preexisting Conditions: Mild Osteoarthritis
Allergies: Bee Stings Ragweed Pollens Cat Dander
Diagnostic Lab Data: None
CDC Split Type:

Write-up: General Itchiness, fatigue, joint inflammation, worsening hives on trunk and extremeties


VAERS ID: 909536 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2020-12-26
Onset:2020-12-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2020-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011J20A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Dizziness, Flushing, Heart rate increased, Throat tightness
SMQs:, Anaphylactic reaction (narrow), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Vestibular disorders (broad), Hypersensitivity (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: Simvastatin (40 mg daily) Levothroxine (75 mcg daily) Pantoprazole (40 mg daily) Advil Vitamin C Vitamin D Daily women''s vitamin
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None.
CDC Split Type:

Write-up: Within two minutes of injection: started feeling flushed, light headed, elevated pulse, and tightening of my throat. Waited 30 minutes at site while physician monitored my symptoms. Flushness, pulse rate and feeling of throat tightness diminished over the 30 minute period and I was released to leave. On the way home I bought Benadryl and took 50 mg. I began to feel more normal 1-2 hours post injection.


VAERS ID: 909542 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Unknown  
Vaccinated:2020-12-26
Onset:2020-12-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2020-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 026 L 20 A / 1 LA / -

Administered by: Private       Purchased by: ?
Symptoms: Cold sweat, Dizziness, Nausea, Paraesthesia, Paraesthesia oral, Sensation of foreign body
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: Minocycline- rash
Diagnostic Lab Data:
CDC Split Type:

Write-up: Waited 15 min without issue. While driving home after approx 10 min developed acute throat fullness, lip tingling, hand tingling, nausea, clammy & lightheaded. Felt like going to pass out. Was able to call 911, pull over. After EMS arrival throat fullness & lightheadedness improved, still with lip tingling. Refused ER went home took Benadryl 50 mg with improvement after a couple hours.


VAERS ID: 909553 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Ohio  
Vaccinated:2020-12-26
Onset:2020-12-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2020-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 039K20A / UNK RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Dysgeusia, Flushing, Hypoaesthesia oral, Paraesthesia oral
SMQs:, Anaphylactic reaction (broad), Taste and smell disorders (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Cozaar
Current Illness: None
Preexisting Conditions: High BP
Allergies: Allergic to Augmentin, Zpak, Erythromycin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Received Moderna vaccine at approximately 4:05pm on 12/26/2020. Within 15 minutes, developed flushed feeling throughout body, developed strange taste in mouth, mouth and tongue felt numb and tingly. Was given 2 Benadryl, symptoms improved, resolved within 6 hours.


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