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

Found 79,643 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'



Case Details

This is page 2 out of 7,965

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VAERS ID: 906836 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Missouri  
Vaccinated:2020-12-21
Onset:2020-12-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2020-12-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011J20A / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Burning sensation, Cough, Headache, Muscle tightness, Nausea, Pain in extremity
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Dystonia (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Nausea, deep harsh dry cough, HA, burning and tightness across shoulder blades. Arm very sore the next morning


VAERS ID: 906858 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Iowa  
Vaccinated:2020-12-22
Onset:2020-12-22
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2020-12-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011J20A / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Dyspnoea, Malaise, Pallor, Palpitations
SMQs:, Anaphylactic reaction (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (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:
Current Illness:
Preexisting Conditions: heart palpitations
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: At the 10 minute mark patient reported not feeling well. She was noted to be pale. Then she reported having slight breathing problems along with her heart racing. Call for ER staff to report to vaccinating area. Patient''s breathing concern resolved on its own by the time ER response team arrived within 2 minutes. Patient slowly gained her color back. Heart palpitations lessening but still reported by patient. Blood pressure / O2 Saturations / Respiratory rate monitored. No oxygen or treatment required at this time. Patient taken upstairs to be monitored by ER staff.


VAERS ID: 906931 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Colorado  
Vaccinated:2020-12-22
Onset:2020-12-22
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2020-12-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011J20A / 1 LA / IM

Administered by: Military       Purchased by: ?
Symptoms: Chest discomfort, Dizziness, Headache
SMQs:, Anaphylactic reaction (broad), 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Epidural steroid injection approximately 10 days prior
Current Illness:
Preexisting Conditions:
Allergies: Shellfish, Iodine, Sulfa
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt experienced headache and dizziness immediately after injection. Approximately 30 mins later the patient began experiencing chest tightness. The patient received 50mg Benadryl and was transferred to the emergency department within about 20 mins.


VAERS ID: 906974 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: North Dakota  
Vaccinated:2020-12-22
Onset:2020-12-22
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2020-12-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025J20-2A / 1 RA / -

Administered by: Private       Purchased by: ?
Symptoms: Feeling hot, Flushing, Hypoaesthesia, Injection site hypoaesthesia, Injection site paraesthesia, Paraesthesia
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Hypersensitivity (broad), Sexual dysfunction (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: Asthma
Allergies: Shellfish
Diagnostic Lab Data: None
CDC Split Type:

Write-up: About 5 minutes after the vaccine was given patient describes numbness and tingling from injection site to pinky and that lasted about 5 minutes. Patient started feeling a flush/warm feeling across chest about 15 minutes after vaccine. No dizziness or lightheadedness. Flushed feeling lasted about 30 seconds. Patient feels much better after 25 minutes of waiting time. She states she does not require any further treatment.


VAERS ID: 906999 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Unknown  
Location: Colorado  
Vaccinated:2020-12-22
Onset:2020-12-22
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2020-12-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025J20-2A / UNK - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Lip swelling, Paraesthesia oral
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), 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? Yes
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: mild swelling and tingeling sensation of the lips. No significant swelling.


VAERS ID: 907022 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Ohio  
Vaccinated:2020-12-22
Onset:2020-12-22
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2020-12-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011J20A / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Anaphylactic reaction, Angioedema, Endotracheal intubation
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Anaphylactic/anaphylactoid shock conditions (narrow), Oropharyngeal allergic conditions (narrow), Hypersensitivity (narrow), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Calcium 600 mg with D daily; Women''s Multiple vitamin daily; Vitamin D3 5,000 units daily; Zyrtec 10 mg at bedtime PRN; Celebrex 200 mg daily; Gabapentin 300 mg (3 caps daily); Melatonin 9 mg daily PRN; Zanaflex 4 mg Daily
Current Illness: Not known
Preexisting Conditions: Anxiety; Depression; Chronic Back Pain
Allergies: Morphine; Tramadol; NSAIDs; Codeine; Oxycodone; Percocet
Diagnostic Lab Data: None at this time
CDC Split Type:

Write-up: Anaphylaxis/Angioedema Patient was given EpiPen 0.3 mg IM; Methylprednisolone 125 mg once; Diphenhydramine 25 mg IV push once; Famotidine 20 mg IV push once; Dexamethasone 10 mg IV push once Patient was intubated and put on propofol and midazolam drips for sedation


VAERS ID: 907032 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Male  
Location: Ohio  
Vaccinated:2020-12-22
Onset:2020-12-22
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2020-12-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 039K20A / UNK LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Pruritus
SMQs:, Anaphylactic reaction (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:
Other Medications: Benedryl 50mg and Pepcid 20mg Tablet
Current Illness: none
Preexisting Conditions: High Blood Pressure
Allergies: no
Diagnostic Lab Data: na
CDC Split Type:

Write-up: States had generalized itching and ask for benedryl. 50mg Benedryl Tablet given PO after 10 minutes ask for Pepcid. After 15 minutes states he feels better and issues resolved


VAERS ID: 907058 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Alaska  
Vaccinated:2020-12-21
Onset:2020-12-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2020-12-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011J20A / 1 RA / IM

Administered by: Military       Purchased by: ?
Symptoms: Swollen tongue, Throat irritation
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Oropharyngeal allergic conditions (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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: cold x3weeks ago. negative for covid.
Preexisting Conditions: Fibromyalgia benign hypermobility syndrome
Allergies: opioids- nausea/vomiting Phenergan - skin/ itchiness
Diagnostic Lab Data: n/a
CDC Split Type:

Write-up: itchiness in throat, mild tongue swelling. Administered Benadryl 50 mg. sx resolved 5-6 minutes after medication administered


VAERS ID: 907075 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Ohio  
Vaccinated:2020-12-22
Onset:2020-12-22
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2020-12-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 039K20A / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Bronchospasm, Cough, Tongue pruritus
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (narrow)

Life Threatening? Yes
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: Influenza - other information unknown
Other Medications: Prescription: atenolol, omeprazole, simvastatin, primidone, levothyroxine, escitalopram, albuterol inhaler
Current Illness: no
Preexisting Conditions: Hypothyroidism, asthma, high cholesterol, palpitations, essential tremor, anxiety, depression, hiatal hernia
Allergies: Medication allergies: morphine - anaphylaxis, flexeril - mood and behavior disturbances, zolpidem- shortness of breath, lamotrigine - shortness of breath Patient had a previous reaction to influenza vaccination with shortness of breath
Diagnostic Lab Data: BMP, CBC w/diff, trop/myoglobin x2, TSH, Free T4, Chest X-ray (all ordered 12/22/20)
CDC Split Type:

Write-up: Patient experienced bronchospasm with coughing and tongue itching approximately 10 minutes after the injection.


VAERS ID: 907081 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: California  
Vaccinated:2020-12-22
Onset:2020-12-22
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2020-12-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011J20A / UNK LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Pruritus, Rash
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: h/o reaction to allergy shot in the past, same feeling with on coming neck/face rash
Other Medications: prebiotic Allegra multi vitamin
Current Illness: none
Preexisting Conditions: cutaneous lupus Rheumatoid arthritis
Allergies: penicillin shellfish
Diagnostic Lab Data: none
CDC Split Type:

Write-up: 1600 Patient c/o itchiness to neck and face felt on coming rash 1625 notified me of reaction, advised to take Benadryl 50mg 1630 notified Pharmacist of reaction 1645 follow up with patient "doing okay" 1700 follow up call feeling the same not worse, leaving work for home, aware to go to ED if symptoms worsens


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