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From the 10/8/2021 release of VAERS data:

Found 84,541 cases where Vaccine is COVID19 and Manufacturer is MODERNA and Standard-MedDRA-Query broadly-matches 'Anaphylactic reaction'



Case Details

This is page 18 out of 8,455

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VAERS ID: 909566 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: New Jersey  
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 / SYR

Administered by: Private       Purchased by: ?
Symptoms: Chest discomfort, Cold sweat, Erythema, Hyperhidrosis, Swelling face, Tachycardia, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Hypersensitivity (narrow), 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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Telmisartin,
Current Illness: None
Preexisting Conditions: Hypertension Sleep apnea Asthma, bronchitis
Allergies: Norvasc, hydroxy chloroquine, hay fever, penicillin,lovinox
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Face became red with hives and swollen., sweating and clammy, chest tight and tachycardia. Went to emergency room. Given Benadryl. Occurred about 8 hours after vaccine


VAERS ID: 909578 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Texas  
Vaccinated:2020-12-27
Onset:2020-12-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2020-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025L20A / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Feeling hot, Pharyngeal swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), 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? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown; undisclosed
Current Illness: None reported; denied acute illness
Preexisting Conditions: None disclosed
Allergies: Unknown; undisclosed; no history of life threatening reaction to any vaccine confirmed
Diagnostic Lab Data:
CDC Split Type:

Write-up: Vaccine administered at 823am; at 0831, patient reported feeling warm and that her throat felt like it was swelling. 0834 pt placed on VSS monitor; 911 called; 0843 Pt was given epi pen 0845/0850 VS repeated; 0851 ambulance arrived and pt taken to ED


VAERS ID: 909579 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Male  
Location: Iowa  
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 025J20-2A / 1 LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Cough, Headache, Hyperhidrosis, Myalgia, Oropharyngeal pain, Pyrexia, SARS-CoV-2 test positive
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (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: Ibuprofen
Current Illness:
Preexisting Conditions: HTN
Allergies: Sulfamethoxazole
Diagnostic Lab Data: 12/26/20 Tested positive for COVID-19
CDC Split Type:

Write-up: Headache Muscle pain Low grade fever Sweating Cough Sore throat


VAERS ID: 909588 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Michigan  
Vaccinated:2020-12-23
Onset:2020-12-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2020-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 039K20A / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Paraesthesia, Rash, Swelling face, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Client reported rash on left side of neck and facial tingling/slight swelling about 4 hours after vaccine; HR 88, BP 130/90 RR 18. Assessed by Medical Director - urticaria most consistent with an allergic reaction. Patient offered Benadryl and encouraged to stay at clinic for observation, but chose to go home - explained risks and danger signs to be aware of that would require immediate visit to ED. Client took 25mg Benadryl at 5pm and MD spoke with her at 6pm - she indicated there was improvement with her rash after the initial dose.


VAERS ID: 909598 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Texas  
Vaccinated:2020-12-26
Onset:2020-12-27
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2020-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037K20A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Erythema, Pruritus, Rash macular
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? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: The ritual prenatal vitamins
Current Illness: None
Preexisting Conditions: None
Allergies: Doxycycline
Diagnostic Lab Data:
CDC Split Type:

Write-up: Splotchy Redness and extreme itching on both left and right arms, hands and feet started itching about an hour later. Took 1 dose of benedryl and redness subsided.


VAERS ID: 909605 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Virginia  
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 039K20A / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Body temperature increased, C-reactive protein, Chest X-ray, Differential white blood cell count, Full blood count, Influenza virus test, International normalised ratio, Lethargy, Liver function test, Prothrombin time, Rash, Swelling face, Swollen tongue, Thinking abnormal, Urine analysis
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Psychosis and psychotic disorders (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: hydrocortisone 15mg synthroid 88mcg
Current Illness: nka
Preexisting Conditions: Empty Cella and Diabetes Insipidus
Allergies: nka
Diagnostic Lab Data: CBC w/dif, chest xray, urinalysis, hepatic function, c-reactive protein, protime-inr, influenza test all done on 12/25/20
CDC Split Type:

Write-up: On December 25th at about 8 pm I became extremely lethargic and unable to think clearly. I had a temperature of 103.7. My face and tongue were swollen and I developed a rash on both lower limbs. I went to Emergency Room and was admitted.


VAERS ID: 909621 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Florida  
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 - / 1 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Arthralgia, Dysphagia, Fatigue, Injection site pain, Injection site swelling, Mouth swelling, Myalgia, Paraesthesia oral, Secretion discharge
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Angioedema (narrow), Anticholinergic syndrome (broad), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), 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: Lyletta IUD, Mito-2-Max (supplement), women?s multivitamin with collagen
Current Illness: None
Preexisting Conditions: Asthma, allergies to dust
Allergies: None nknown
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Almost immediately following vaccine administration I had tingling in my lips, followed by swelling and tingling of my soft palate. It was minimal and became worse at around 20min following the vaccine. I had left the facility and was having some increased mucous production. No difficulty breathing, but I had some slight difficulty swallowing. I took 50mg of Benadryl and after about 1.5 hours the symptoms had resolved. Now over 24 hours out. I have some swelling of my right bicep, as well as some tenderness with right elbow and right wrist pain. Some myalgia worse in my right shoulder and right sciatic area and right thigh. Slight fatigue.


VAERS ID: 909625 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2020-12-24
Onset:2020-12-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2020-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA #037K20A / 1 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Blood glucose increased, Rash, Rash erythematous
SMQs:, Anaphylactic reaction (broad), Hyperglycaemia/new onset diabetes mellitus (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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Synthroid, Humalog, Ramipril, salmon oil (omega 3), zinc, Vitamin D3, Vitamin C, Pravastatin, Cetirizine Hydrochloride, Low dose aspirin, Calcium, Protandim, Timolol Maleate Ophthalmic solution
Current Illness: none
Preexisting Conditions: Type 1 Diabetic, Glaucoma
Allergies: Simvastatin, Codeine, Travoprost, Down feathers, Environmental (rhinitis/sneezing)
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Red rash on left forearm and back of left hand. Lasted 48 hours. High, uncontrolled blood glucose, unable to correct using insulin pump and additional insulin delivery. (Held over 300 mg/dl) Lasted 30 hours. Within 48 hours all symptoms alleviated.


VAERS ID: 909628 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Pennsylvania  
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 026L20A / 1 RA / IM

Administered by: Work       Purchased by: ?
Symptoms: Dysphagia, Dysphonia, Hypoaesthesia oral, Lip swelling, Nausea
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (narrow), Anticholinergic syndrome (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Anastrozole, multivitamin, fish oil, Ca+D, 81mg ASA
Current Illness: Treatment for breast cancer
Preexisting Conditions: See above
Allergies: Latex, latex products, bananas, kiwis, walnuts, Vicodin
Diagnostic Lab Data:
CDC Split Type:

Write-up: 35min after injection. Swollen, numb lips, hoarse voice, difficulty swallowing, nausea. Patient is RN and self treated with 50mg benadryl, zyrtec, and caffeine. Patient was somnolent for several hours with concurrent nausea. Reported full resolution of symptoms within 6 hours. .


VAERS ID: 909632 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Hawaii  
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 011520A / UNK LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood potassium decreased, Body temperature increased, Dizziness, Electrocardiogram normal, Flushing
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Vestibular disorders (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypokalaemia (narrow)

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: Loratidine 10mg taken @ approximately 630am that morning
Current Illness: No known illnesses
Preexisting Conditions: hyperlipidemia
Allergies: No known allergies
Diagnostic Lab Data: 12/26/2020- EKG- sinus rhythm abnormal Labs K+ 3.3
CDC Split Type:

Write-up: approximately 1.5 hrs after my vaccine I started to feel lightheaded and flushed all over my body. My heart rate was 120''s and my temperature was 100.2F. No difficulty breathing, SOB, chest pain or rash. I was checked into the clinic and monitored in the Nurse Treatment Center. I was placed on a bedside cardiac monitor, an EKG was done, labs drawn and IV fluids administered. I was there for approx 1 hr and discharged to home. Temp was 99.1 HR 100''s.


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