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From the 1/14/2022 release of VAERS data:

Found 41,515 cases where Vaccine targets COVID-19 (COVID19) and Manufacturer is MODERNA and Serious

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Case Details

This is page 21 out of 4,152

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VAERS ID: 932915 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: Washington  
Vaccinated:2020-12-29
Onset:2021-01-08
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-01-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037K20A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Contusion, Haematocrit normal, Haemoglobin normal, Mean cell haemoglobin concentration normal, Mean cell haemoglobin normal, Mean cell volume normal, Mouth haemorrhage, Platelet count decreased, Red blood cell count normal, Red cell distribution width normal, Thrombocytopenia, White blood cell count normal
SMQs:, Haematopoietic thrombocytopenia (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Systemic lupus erythematosus (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Accidents and injuries (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Zoloft (sertraline), vitamin D, cetirizine (zyrtec)
Current Illness: None
Preexisting Conditions: Anxiety, history of anti-thyroglobulin antibodies
Allergies: None
Diagnostic Lab Data: CBC 1/8/21 - WBCs 8.65, RBCs 4.47, Hg 13.7, Hct 40, MCV 89, MCH 30.6, MCHC 34.3, Plts 1** (d) C, RDW 11.8%.
CDC Split Type:

Write-up: Severe thrombocytopenia (plts 3k/uL), oral mucosal bleeding, bruising


VAERS ID: 933025 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Arizona  
Vaccinated:2020-12-21
Onset:2020-12-28
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-01-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / -

Administered by: Other       Purchased by: ?
Symptoms: Angiogram cerebral normal, Anion gap, Arteriogram carotid normal, Blood calcium normal, Blood chloride normal, Blood creatinine normal, Blood glucose normal, Blood potassium decreased, Blood sodium normal, Carbon dioxide decreased, Computerised tomogram head abnormal, Encephalitis, Glomerular filtration rate normal, Glycosylated haemoglobin normal, Headache, Hypokalaemia, Inflammation, Ketonuria, Magnetic resonance imaging brain normal, Oral herpes, Platelet count normal, Posterior reversible encephalopathy syndrome, Urine ketone body present, White blood cell count normal
SMQs:, Hyperglycaemia/new onset diabetes mellitus (narrow), Oropharyngeal infections (narrow), Noninfectious encephalitis (narrow), Noninfectious encephalopathy/delirium (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypokalaemia (narrow), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: methimazole 2.5 mg daily, MVI, D3, B12
Current Illness: none
Preexisting Conditions: hyperthyroidism
Allergies: None
Diagnostic Lab Data: CBC: normal WBC, no anemia, normal platelet BMP: glucose 115, eGFR 96 Cr 0.76, Na 136, K 3.3, Cl 101 CO2 22, AG 13, Ca 9.2 urine + ketones (small) CT head: IMPRESSION: 1. No evidence of acute parenchymal hemorrhage 2. Patchy areas of hypodensity noted within the occipital lobes bilaterally greater on the left than the right. Findings favored to represent underlying posterior reversible encephalopathy syndrome, further evaluation with MRI of the brain is warranted. CT angio head/neck Impression: 1. No evidence of significant stenosis, vascular occlusion, arterial dissection extracranial vasculature of the neck 2. No evidence of significant stenosis, vascular occlusion, arterial aneurysm the arteries of the circle of Willis MRI brain w/o contrast IMPRESSION: No evidence of an acute intracranial process. Essentially unremarkable examination of the brain without distinct findings to indicate PRESS syndrome. 12/29 labs indicated resolution of hypokalemia and ketonuria. Hgb A1c 5.5%.
CDC Split Type:

Write-up: Sudden, severe worst headache of her life, coupled with onset of oral herpetic lesions and inflammation to unrelated body part (belly button piercing) occurred one week after vaccination received. She presented to ED 12/28 noted to have hypokalemia and head CT showed mild occipital encephalitis, admitted overnight for obs subsequent brain MRI was normal. She was seen in my clinic 2 days later (1/4/21) and was started on 3 day course of Decadron, topical acyclovir for herpetic lesion. As she is a nurse, I kept her off work until resolution of symptoms. Seen again on 1/8/21, headache resolved. She did discuss CT and MRI results with neurologist. He was not convinced this was vaccine related. She is having 2nd dose of vaccine on 1/11/21.


VAERS ID: 933101 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Male  
Location: Ohio  
Vaccinated:2020-12-31
Onset:2020-12-31
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-01-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011L20A / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Bursitis, Injected limb mobility decreased, Injection site discomfort, Injection site pain, Loss of personal independence in daily activities, Magnetic resonance imaging abnormal, Shoulder injury related to vaccine administration, Sleep disorder, Tendon disorder
SMQs:, Dementia (broad), Extravasation events (injections, infusions and implants) (broad), Tendinopathies and ligament disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Wellbutrin
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: MRI SHOULDER RIGHT - Details Study Result Impression 1. Supraspinatus and infraspinatus bursal surface tendinopathy without tear. 2. Anterosuperior glenoid labral tear with small intrasubstance paralabral cysts. 3. Subacromial/subdeltoid bursitis. Narrative HISTORY: Acute pain of right shoulder. COMPARISON: None. TECHNIQUE: Noncontrast multiplanar MR images were obtained of the right shoulder. FINDINGS: Rotator cuff: There is focal bursal surface thickening and hyperintensity of the infraspinatus critical-zone and insertion, and the supraspinatus leading-edge insertion. No significant intrasubstance or surface tear is evident. Subscapularis and teres minor tendons are normal. Muscle bulk is maintained. Glenoid labrum: Linear signal abnormality extends from the 12:00 through 2:00 positions anterior superiorly, with associated intralabral cysts measuring 0.7 x 0.5 x 0.7 cm. Glenohumeral articular cartilage: Normal. Long head biceps tendon: Normal. Coracoacromial arch: Acromioclavicular joint is normal. Acromion is type- II. There is no anterior or lateral acromial downsloping or spur. Marrow: Normal. Miscellaneous: Subacromial/subdeltoid bursal effusion is moderate.
CDC Split Type:

Write-up: Moderna vaccine dose #1 received in right shoulder on 12/31/20 at 2:15PM. Injection was uneventful other than sensation of pressure. I did notice at the time, but could not fully see, that the injection appeared to be much higher on the shoulder than normal. I immediately came home afterwards and relaxed. Approximately 2hrs later, I began experiencing extreme pain in my right shoulder. As the night progressed, the pain worsened to 10/10 with inability to move my arm. Later that night after requiring assistance to take off my shirt, I noticed that the bandaid overlying the injection site was very high, immediately below and bordering the acromion process. This was concerning but I was hopeful the pain would go away over the next few days. I took tylenol that night. I woke up multiple times during the night because the pain was so severe. When I woke up, the pain and inability to move my arm were still present. I began taking 800mg ibuprofen and 1000mg tylenol alternating Q4 throughout the next few days. The pain and disability remained so severe that I required assistance performing ADLs for the next 4 days. On day four, with the pain not resolved and still severe despite consistent advil and tylenol use, I began having concern for shoulder injury related to vaccine administration. The next day I decided to seek an evaluation by an orthopedist. I am a physician and was unable to perform basic tasks and ADLs. I happened to have a few days off after the injection but would not have been able to work had I not. After an evaluation by the an orthopedic PA, I obtained an MRI of my right shoulder with results shown below - as I expected evidence of rotator cuff tendinopathy and subdeltoid bursitis consistent with SIRVA. As of now, I still have limited range of motion and shoulder pain on the right which has improved slightly but is far from resolved. I still have difficulty with certain ADLs including putting clothes on and off, lifting items, and tasks that require raising my right arm above my head. I am concerned with the possibility of long term and/or permanent damage after reviewing the literature. I am also concerned about how many other healthcare workers the person who gave me my vaccine may be injuring and/or causing permanent harm to.


VAERS ID: 933142 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Arizona  
Vaccinated:2020-12-31
Onset:2020-12-31
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-01-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Alopecia, Blood glucose increased, Chest X-ray, Cough, Dizziness, Dysphonia, Dyspnoea, Epistaxis, Eye swelling, Full blood count, Headache, Injection site pain, Mental impairment, Pharyngeal swelling, Swelling, Swelling face, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Hyperglycaemia/new onset diabetes mellitus (narrow), Anticholinergic syndrome (broad), Dementia (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Sinus infection
Preexisting Conditions: DM 1.5, tachycardia
Allergies: PCN,Morphine, nuts, pumpkin, sour cream.
Diagnostic Lab Data: Full blood, chest X-ray.
CDC Split Type:

Write-up: Pain at site of injection, eyes, throat, face swelling. Unclear thinking, hoarse speech, headache, hives, swelling. Intervention taken immediately. Ongoing 11 days: SOB, headaches, nose bleeds, coughing, blood sugars triple, hair falling out, major swelling, dizziness.


VAERS ID: 951288 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Female  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-01-06
Submitted: 0000-00-00
Entered: 2021-01-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 039K20A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Blood potassium decreased, Dyspnoea, Respiratory depression
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (narrow), Pulmonary hypertension (broad), Cardiomyopathy (broad), Respiratory failure (narrow), Hypokalaemia (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? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: RespDepression found to have low potassium Narrative: Patient reports experiencing shortness of breath 24 hours after the vaccine was administered, went to ER and admitted for one night. Informed her supervisor she had low potassium.


VAERS ID: 933578 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Male  
Location: New York  
Vaccinated:2021-01-08
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2021-01-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 012L20A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Death
SMQs:

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 0000-00-00
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: metform, atorvastin
Current Illness: Diabetes, Hypertension, Sleep Apnea, Obese
Preexisting Conditions: Hx smoking
Allergies: NKA
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pronounced dead 1/9/2021 at 12:42. Received first dose of vaccine 1/8/2021


VAERS ID: 933751 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-01-11
Onset:2021-01-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-01-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011L20A / 1 LA / IM

Administered by: Military       Purchased by: ?
Symptoms: Dyspnoea, Malaise, Oxygen saturation normal, Throat tightness
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (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? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Advair 500/50, Spriva 2.5mcg, Asmanex 220mcg, Metformin 100mcg, Nexium 20mg, Montelekast, Baby asprin 81 mg, Lovastatin, Nosonex, Pro Air, Duo Neb, Epi Pen 0.3 mg Busporine 150 Mg, Theophylin 400mg.
Current Illness:
Preexisting Conditions:
Allergies: Shell Fish, Cologne, Perfume, Hand sanitizer, penicillin, Zpac, coconut, peanuts
Diagnostic Lab Data:
CDC Split Type:

Write-up: Aprox 5 minutes after vaccine was given, patient stated he was not feeling well, asked for water and stated he was having trouble breathing. Was then assisted to clinic treatment room, vitals were taken: 08:45 B/P 171/110, HR 84, R 28 O2 97. EMS was activated. At 0900 158/94 HR 84 R 24 O2 97. Patient then voice he was having tightness in his throat. Epi Pen 0.3mg administered at 0900. At 0904 EMS arrived and patient taken to the nearest hospital.


VAERS ID: 933792 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Maine  
Vaccinated:2020-12-23
Onset:2021-01-01
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-01-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011J20A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Neurological symptom
SMQs:

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? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Manager was notified that the employee had suffered a stoke-like "serious medical event" hours after the end of her shift, while at home.


VAERS ID: 933846 (history)  
Form: Version 2.0  
Age: 91.0  
Sex: Female  
Location: West Virginia  
Vaccinated:2021-01-02
Onset:2021-01-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-01-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 077L20A / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Back pain, Cardiac disorder, Death, Dizziness, Pain in extremity
SMQs:, Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Vestibular disorders (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-01-04
   Days after onset: 2
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: MACULAR DEGENERATION 10 YEARS OR MORE
Preexisting Conditions: NONE
Allergies: NKDA
Diagnostic Lab Data:
CDC Split Type:

Write-up: 1-2-2021 10:30 PM Complained Right arm/back hurt - took Tylenol 1-3-2021 Complained Right arm hurt, dizzy 1-4-2021 Felt better - did laundry, daughter found her deceased at 3:30 pm. Dr. at hospital said it was "cardiac event" according to death certificate.


VAERS ID: 933913 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-01-07
Onset:2021-01-08
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-01-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK RA / IM

Administered by: Senior Living       Purchased by: ?
Symptoms: Fatigue, Myalgia, Respiratory rate increased
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (broad), 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? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Prescription 03/19/2019 - Open Ended metoprolol succinate tablet extended release 24 hr; 50 mg; amt: 50 mg; oral Special Instructions: Hold for SBP <100 or HR <60 Once A Day; Upon Rising Prescription 07/12/2019 - Open Ended Ampyra (dalfamp
Current Illness:
Preexisting Conditions: Neuromuscular dysfunction of bladder, unspecified 02/26/2018 R13.13 Dysphagia, pharyngeal phase 03/06/2020 G35 Multiple sclerosis 02/26/2018 K58.9 Irritable bowel syndrome without diarrhea 02/26/2018 I50.9 Heart failure, unspecified 02/26/2018 K21.9 Gastro-esophageal reflux disease without esophagitis 02/26/2018 F33.1 Major depressive disorder, recurrent, moderate 03/18/2019 I10 Essential (primary) hypertension 02/26/2018 F41.1 Generalized anxiety disorder 02/26/2018 F39 Unspecified mood [affective] disorder 02/26/2018 H04.129 Dry eye syndrome of unspecified lacrimal gland 02/26/2018 G47.8 Other sleep disorders 04/04/2019 E87.5 Hyperkalemia 11/13/2018 M62.838 Other muscle spasm 02/26/2018 J30.9 Allergic rhinitis, unspecified 11/25/2019 R26.2 Difficulty in walking, not elsewhere classified 09/14/2018 E53.8 Deficiency of other specified B group vitamins 06/28/2018 E55.9 Vitamin D deficiency, unspecified 02/26/2018 E56.8 Deficiency of other vitamins 02/26/2018 R42 Dizziness and giddiness 02/26/2018 R52 Pain, unspecified 02/26/2018 R13.13 Dysphagia, pharyngeal phase (History of) 05/10/2019 R53.1 Weakness 09/14/2018 R26.81 Unsteadiness on feet 03/06/2020 R26.89 Other abnormalities of gait and mobility 03/06/2020 M62.81 Muscle weakness (generalized) 02/26/2018 Z51.89 Encounter for other specified aftercare 10/03/2018 Z86.16 Personal history of COVID-19 Note:June 2020 01/07/2021 R26.2 Difficulty in walking, not elsewhere classified 07/17/2020 R26.81 Unsteadiness on feet 07/17/2020 R26.89 Other abnormalities of gait and mobility 07/17/2020 G35 Multiple sclerosis
Allergies: gabapentin, guaifenesin, Penicillins (PCN)
Diagnostic Lab Data:
CDC Split Type:

Write-up: Upon assessment resident noted to have increased respirations, lungs CTA. Resident c/o increased fatigue and muscle aches. VS 202/180, 118, 22, 97.1, 96%.


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