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

Found 90,569 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 22 out of 9,057

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VAERS ID: 909993 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Arizona  
Vaccinated:2020-12-23
Onset:2020-12-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2020-12-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / SYR

Administered by: Private       Purchased by: ?
Symptoms: Pruritus, Rash, Throat irritation
SMQs:, Anaphylactic reaction (broad), 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Face Started itching, Throat felt weird, rash started appearing on both arms


VAERS ID: 909995 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: New York  
Vaccinated:2020-12-24
Onset:2020-12-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2020-12-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 RA / IM

Administered by: Work       Purchased by: ?
Symptoms: Pain in extremity, Pruritus, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Tendinopathies and ligament disorders (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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: medication for overactive bladder; she cannot recall name
Current Illness: denies
Preexisting Conditions: overactive bladder, polycystic kidneys, uterine fibroids
Allergies: denies
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Aching in right arm, then pruritus, then swelling. Went to ED immediately since she was at work when reaction began. In ED was given prednisone, Pepcid, Benadryl.


VAERS ID: 910003 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Unknown  
Vaccinated:2020-12-26
Onset:2020-12-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2020-12-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 039K20-2A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Akathisia, Dyspnoea, Palpitations, Panic reaction
SMQs:, Anaphylactic reaction (broad), Arrhythmia related investigations, signs and symptoms (broad), Akathisia (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (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: none
Current Illness: none
Preexisting Conditions: none
Allergies: latex-rash
Diagnostic Lab Data: none
CDC Split Type:

Write-up: 10 min-heart palpitations 20 min-heart palpitations, could not catch breath, angst/panicky sensation, all intermittent 1 hour- akathisia, heart palpitations/panicky sensation, all intermittent, resolved with benadryl 24 hours- heart palpitations/panicky sensation, intermittent


VAERS ID: 910006 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Alabama  
Vaccinated:2020-12-23
Onset:2020-12-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2020-12-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Asthenia, Chills, Cough, Dysphonia, Headache
SMQs:, Anaphylactic reaction (broad), Parkinson-like events (broad), Guillain-Barre 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: Synthroid, Zoloft, Coozar, Lipitor, Anbien, Olumiant, Tizanidine, baby Aspirin.
Current Illness:
Preexisting Conditions: Reumathoid arthritis.
Allergies: Kenalog, depo-medrol.
Diagnostic Lab Data:
CDC Split Type:

Write-up: Headache, chills, horseness, weakness, cough.


VAERS ID: 910007 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Male  
Location: Michigan  
Vaccinated:2020-12-23
Onset:2020-12-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2020-12-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011J20A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Ageusia, Anosmia, Asthenia, Balance disorder, Body temperature increased, Chills, Dizziness, Fatigue, Feeding disorder, Headache, Hyperhidrosis, Injection site nodule, Injection site pain, Injection site pruritus, Injection site reaction, Injection site swelling, Nausea, Pain, Rash erythematous, Tremor, Weight decreased
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Vestibular disorders (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Immune-mediated/autoimmune 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: None
Current Illness: None
Preexisting Conditions: None
Allergies: PCN
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Day 1: approximately 1 hours after vaccine - dizziness, extremely tired, dosing off, , injection site tender, approximately the size of a dime knot at injection site. Day 2: body aches all over, moderate headache, extremely tired, no energy, about 1700 hours: profuse sweating, full body chills accompanied with entire body shakes, extreme headache, nauseated, unable to eat, lose of taste and smell, extreme body aches, sense of falling. Lasted for 36 hours, lost 7 lbs. Swelling at injection site, followed by a knot in arm approximately size of a quarter, raised approximately 1 ", red rash and extreme itching. Day 3/4: symptoms subsiding, rash and pain in arm increasing. Rash spread from elbow and shoulder, raised approximately 2" and almost encompassed entire upper arm, approximately 1" gap on the inside of arm not affected. Day 5: Started feeling human again. Temperature was never higher than 99.5 degrees. Took Aleve and Tylenol


VAERS ID: 910041 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Mississippi  
Vaccinated:2020-12-24
Onset:2020-12-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2020-12-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037K20A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chills, Diarrhoea, Dyspnoea, Nausea, Pyrexia
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Noninfectious diarrhoea (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Approximately 17 hours following vaccination, recipient experienced fever, chills, shortness of breath, nausea, diarrhea.


VAERS ID: 910054 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Florida  
Vaccinated:2020-12-23
Onset:2020-12-25
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2020-12-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011J20A / UNK RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Rash, Rash erythematous, Rash macular, Rash pruritic
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:
Other Medications: Singulair, Annuity Ellipta, Azelastine nasal spray, Folate, COq10, Fish Oil, Vitamin D, Vitamin B12
Current Illness: Asthma, Non-allergic rhinitis
Preexisting Conditions: Asthma, Non-allergic rhinitis
Allergies: Sulfite and fragrance (asthma)
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Developed red, blotchy, mildly itchy rash to anterior and posterior neck on the morning of 12/25/2020 (rec''d vax afternoon of 12/23/2020). The rash progressed throughout the day; extending to anterior torso down to waist, right arm, and upper back. Took 25mg benadryl tablet. Rash began improving the next afternoon (12/26/2020) and completely resolved by morning of 12/28/2020.


VAERS ID: 910057 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Colorado  
Vaccinated:2020-12-23
Onset:2020-12-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2020-12-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025J20-2A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Abdominal pain upper, Dyspnoea, Pain, Sleep disorder, Spinal pain
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Arthritis (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: KYLENA, IDU
Current Illness: NONE
Preexisting Conditions: PCOS
Allergies: NONE
Diagnostic Lab Data: I have chosen not to f/u with a visit. I am an emergency room nurse & have spoken with my PCP & MD coworkers.
CDC Split Type:

Write-up: About 8 hours post vaccine, at 2300 as I was going to bed I felt what I would describe as breathing resistance. I would not describe it as chest pain/pressure/tightness or SOB. It was just upper chest resistance to inhalation when lying down for bed. 12/24 started with intermittent gnawing epigastric during the day. Persisted through the night with gnawing epigastric pain radiating through to my spine, i was unable to sleep due to the pain. Attempted tums (I do not have GERD), motrin & tylenol however, nothing was helpful. 12/25 & 12/26 same symptoms persisted both day and night 12/27 asymptomatic 12/28 cramping/twisting epigastric pain returned, much more mild


VAERS ID: 910059 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2020-12-23
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2020-12-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025J20A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Acute kidney injury, Endotracheal intubation, Gait inability, Hypoaesthesia, Pyrexia, Respiratory failure
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Anaphylactic reaction (broad), Angioedema (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), 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), Dystonia (broad), Acute central respiratory depression (narrow), Guillain-Barre syndrome (broad), Hypersensitivity (broad), Tumour lysis syndrome (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad), Hypokalaemia (broad), Sexual dysfunction (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: Cetirezen 10 mg Daily, Lasix 20 Mg daily, Gabapentin 400 bid, Glipizide 5 mg daily, lisnopril 5 mg daily, Levothyroxine25mcg daily, Metoxican 7.5 daily, Sertraline 50 daily
Current Illness: none
Preexisting Conditions: Depression, Diabetes ,Hypertension, Hypothyroidism, Obesity
Allergies: Pencillian
Diagnostic Lab Data:
CDC Split Type:

Write-up: Numbness in sole of feet. Unable to walk, develop high fever, resp failure resulting in intubation, acute kidney injury


VAERS ID: 910062 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Indiana  
Vaccinated:2020-12-28
Onset:2020-12-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2020-12-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 026L20A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Hyperhidrosis, Hypotension, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad), Dehydration (broad), Hypokalaemia (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Diaphoresis, syncope, and hypotension.


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