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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 22 out of 4,152

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VAERS ID: 933935 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-01-02
Onset:2021-01-10
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-01-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025J20A / 1 AR / IM

Administered by: Private       Purchased by: ?
Symptoms: Haemoglobin normal, Immune thrombocytopenia, Platelet count decreased, Thrombocytopenia, White blood cell count normal
SMQs:, Haematopoietic thrombocytopenia (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Systemic lupus erythematosus (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? Yes
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: Omeprazole
Current Illness: None
Preexisting Conditions: GERD
Allergies: NKDA
Diagnostic Lab Data: CBC showed platelet count of 2,000. WBC and Hgb normal
CDC Split Type:

Write-up: Sever thrombocytopenia (platelet count 2,000) 8 days following Moderna COVID vaccine. Clinically suspicious for ITP.


VAERS ID: 933965 (history)  
Form: Version 2.0  
Age: 81.0  
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 LA / IM

Administered by: Senior Living       Purchased by: ?
Symptoms: Blood glucose increased, Confusional state, Discomfort, Myalgia, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Hyperglycaemia/new onset diabetes mellitus (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), 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? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: allopurinol tablet; 300 mg; amt: 300mg; oral Once A Day; Upon Rising Prescription 04/06/2019 - Open Ended furosemide tablet; 40 mg; amt: 40mg; oral Once A Day; Upon Rising Prescription 04/06/2019 - Open Ended levothyroxinet tablet; 50 mcg;
Current Illness:
Preexisting Conditions: E11.9 Type 2 diabetes mellitus without complications 09/14/2018 J98.4 Other disorders of lung Note:restrictive lung disease 09/14/2018 D50.9 Iron deficiency anemia, unspecified 09/14/2018 E78.5 Hyperlipidemia, unspecified 09/14/2018 I73.9 Peripheral vascular disease, unspecified 09/14/2018 I48.0 Paroxysmal atrial fibrillation 09/14/2018 I13.0 Hypertensive heart and chronic kidney disease with heart failure and stage 1 through stage 4 chronic kidney disease, or unspecified chronic kidney disease 04/06/2019 F41.9 Anxiety disorder, unspecified 09/14/2018 F33.1 Major depressive disorder, recurrent, moderate 02/21/2019 M19.90 Unspecified osteoarthritis, unspecified site 04/06/2019 E03.9 Hypothyroidism, unspecified 09/14/2018 F41.0 Panic disorder [episodic paroxysmal anxiety] 09/14/2018 R44.3 Hallucinations, unspecified 09/14/2018 M10.9 Gout, unspecified 09/14/2018 I50.32 Chronic diastolic (congestive) heart failure 11/01/2018 N18.3 Chronic kidney disease, stage 3 (moderate) 04/06/2019 K30 Functional dyspepsia 09/14/2018 R45.1 Restlessness and agitation 09/14/2018 G47.00 Insomnia, unspecified 09/14/2018 M53.87 Other specified dorsopathies, lumbosacral region Note:DJD 09/14/2018 E04.2 Nontoxic multinodular goiter 09/14/2018 R29.6 Repeated falls 11/01/2018 R26.2 Difficulty in walking, not elsewhere classified 09/14/2018 M62.81 Muscle weakness (generalized) 09/14/2018 R53.1 Weakness 11/01/2018 R26.81 Unsteadiness on feet 09/14/2018 E66.01 Morbid (severe) obesity due to excess calories 09/14/2018 Z87.440 Personal history of urinary (tract) infections 04/07/2019 Z87.891 Personal history of nicotine dependence 04/06/2019 Z87.81 Personal history of (healed) traumatic fracture 04/06/2019 Z51.89 Encounter for other specified aftercare 09/14/2018 R50.9 Fever, unspecified 07/20/2020 R26.89 Other abnormalities of gait and mobility 04/24/2020 L97.811 Non-pressure chronic ulcer of other part of right lower leg limited to breakdown of skin 09/27/2019 M15.0 Primary generalized (osteo)arthritis
Allergies: codeine phosphate (bulk), enalapril maleate, oxycodone-aspirin, Penicillins (PCN)
Diagnostic Lab Data:
CDC Split Type:

Write-up: Found on floor by CNA at 6 am. On assessment by charge nurse, VS: 99.6-94-16 212/105 manual. Noted increased confusion. Temp. 99.6 FBS 114. Resident had been provided tylenol just prior in shift for general discomfort (sore muscles) and low grade temp. On call for Dr notified of all and received order to send to ER.


VAERS ID: 934050 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Male  
Location: Kansas  
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 025J202A / 1 - / IM

Administered by: Senior Living       Purchased by: ?
Symptoms: Death, Fall, Posture abnormal, Resuscitation, Unresponsive to stimuli
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-01-08
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Patient was a resident in Group Home Current Medications Treatments/PRN Medications: Start Date: 04/02/14: Benztropine 2mg tab BID (8-8) 02/27/15: Midodrine (Proamatine) 5mg tab TID (8-12-8) 12/30/15: Cetirizine 10mg tab daily @8am 1
Current Illness: No Acute Illnesses
Preexisting Conditions: Diagnosis: - Impulse Control Disorder - Epilepsy - Tardive Dyskinesia - Ulcerative Proctitis and Colitis - Mental Retardation (mod) - Hammer toes (bilat.) - Dermatitis (scalp/torso) - Seborrheic keratosis of left armpit - Major Depression - Infantile Meningitis - History of Squamous Cell Carcinoma (L arm)
Allergies: Allergies: NKDA
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Staff reported that patient was found Friday morning (Jan 8) sitting at a table with his head tilted forward and unresponsive to verbal or physical stimuli. Staff lowered patient to floor and started CPR. EMS was called and continued CPR at scene, however they were not able to revive patient. Patient was pronounced dead at the scene. Staff written statements following the death of patient show that he had a fall about 1 hr. prior. It is unknown if this fall contributed to patient''s death. An autopsy has been requested.


VAERS ID: 934099 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Illinois  
Vaccinated:2020-12-28
Onset:2020-12-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-01-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 UN / IM

Administered by: Private       Purchased by: ?
Symptoms: Burning sensation, Diarrhoea, Laboratory test, Nausea, Rash, Rash pruritic, Throat tightness
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (broad), Angioedema (broad), Peripheral neuropathy (broad), Pseudomembranous colitis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), 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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: topomax, melatonin, mirena ring, B12 injection, zyrtec, biotin
Current Illness: none
Preexisting Conditions: anxiety, depression, hyperprolactinemia, migraines, primary hypothyroidism
Allergies: ? shellfish (positive skin test but eats shellfish with "no problem")
Diagnostic Lab Data: just basic labs
CDC Split Type:

Write-up: Patient is a 41 y.o. female who presented to the ED with complaints of a reaction after she took the COVID vaccine. Patient is an RN here and had earlier received COVID-19 vaccination (Moderna) around 0130 this afternoon. Soon after she experienced rash which was burning and itchy on her arms thighs and back. She reported to Occ health and was directed to the ED. While in the ED she experienced throat tightness and nausea. She had one episode of diarrhea. No tongue, lip swelling, SOB or difficulty swallowing. Denies any chest pain, palpitations, pre-syncope/syncope. No vomiting abdominal pain. H/o of allergy to fish mix and dust mite.


VAERS ID: 934156 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-01-05
Onset:2021-01-07
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-01-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 026L20A / 1 RA / IM

Administered by: Senior Living       Purchased by: ?
Symptoms: Chills, Intensive care, Laboratory test, Pain, Unresponsive to stimuli
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Tylenol, Atenolol, LIpitor, Clonidine, mutlivitamin, Lasix, Gabapentin, Losartan, Maalox, Miralax, Zofran, Vitamin D2.
Current Illness: No
Preexisting Conditions: 2019-nCoV acute respiratory disease, Hyperlipidemia, unspecified, Chronic obstructive pulmonary disease, unspecified, Other hereditary and idiopathic neuropathies, Essential (primary) hypertension, Peripheral vascular disease, unspecified, Venous insufficiency (chronic) (peripheral), Other chronic pain, Type 2 diabetes mellitus with hyperglycemia, Dehydration, Nondisplaced oblique fracture of shaft of left fibula, sequela, Vitamin D deficiency, unspecified, Nondisplaced fracture of second metatarsal bone, left foot, subsequent encounter for fracture with routine healing, Nondisplaced fracture of third metatarsal bone, left foot, subsequent encounter for fracture with routine healing, Nondisplaced fracture of fourth metatarsal bone, left foot, subsequent encounter for fracture with routine healing, Hypokalemia, Acute respiratory failure with hypoxia, Muscle weakness (generalized), Difficulty in walking, not elsewhere classified, Cognitive communication deficit, Non-pressure chronic ulcer of other part of left lower leg with fat layer exposed, Repeated falls, Cellulitis of right lower limb, Cellulitis of left lower limb, Other iron deficiency anemias, Other recurrent depressive disorders, Hypothyroidism, unspecified, Chronic venous hypertension (idiopathic) with ulcer of bilateral lower extremity, Diabetes mellitus due to underlying condition with other skin complications, Other constipation, Chronic respiratory failure with hypoxia, Other acute kidney failure, Lymphedema, not elsewhere classified, Generalized edema, Morbid (severe) obesity due to excess calories, Chronic ischemic heart disease, unspecified, Gastro-esophageal reflux disease without esophagitis, Disorder resulting from impaired renal tubular function, unspecified, History of falling, Cellulitis/abscess, leg, Impaired renal function NOS, Hypertension, benign essential
Allergies: Bactrim, Kefles, PCN
Diagnostic Lab Data: All tests done at the Hospital
CDC Split Type:

Write-up: 01/06/21 at 6 pm, body aches, and chills 01/07/21 at 12am T102.2, SPO2 62% on room air. Was sent to ER and returned. 01/08/21 at SPO@ less then 60% on room air, non responsive to verbal tactile stimuli. Responsive to sternal rub only. Was sent to ER and admitted to ICU.


VAERS ID: 934263 (history)  
Form: Version 2.0  
Age: 92.0  
Sex: Male  
Location: New Mexico  
Vaccinated:2020-12-30
Onset:2021-01-01
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-01-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / UN

Administered by: Senior Living       Purchased by: ?
Symptoms: Death, Malaise, SARS-CoV-2 test positive
SMQs:, Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-01-02
   Days after onset: 1
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: Again, I cannot confirm the results of any test, i.e., COVID or other, because the patient is independent and sought care independent of the center.
CDC Split Type:

Write-up: The resident resides in an independent living facility/apartment. The reporter at the center was informed by his daughter he was not feeling well on 1/1/2021 (specific symptoms could not be ascertained). He reportedly went to be COVID tested on 1/1/2020 and observed to be deceased in his apartment on 1/2/2020. I do not have confirmation of his COVID results, although the reporter indicates his daughter reports his test was positive.


VAERS ID: 934539 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-01-08
Onset:2021-01-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-01-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA D12L20A / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Autopsy, Blood test, Culture tissue specimen, Death, Toxicologic test, Unresponsive to stimuli
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-01-09
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Singulair, Oxybutynin, Fosamax, Prednisone, Meloxicam, Eliquis, Bumetanide, Triamcinolone cream, Klor-Con, Lisinopril, Promethazine,
Current Illness: Cellulitis of left lower limb (12/2020)
Preexisting Conditions: Hypertension
Allergies: No known allergies
Diagnostic Lab Data: Postmortem examination was performed at the State Medical Examiner Office on January 10, 2021 (MEC21-0019). Tissue samples were obtained for histology and red top/tiger top/purple top tubes of blood were obtained for potential further studies. Samples of blood and vitreous humor were also obtained and submitted to AXIS Laboratories for toxicologic analysis.
CDC Split Type:

Write-up: Patient received COVID-19 (Moderna) vaccine from the Health Department on afternoon of January 8, 2021 and went to sleep approximately 2300 that night. Was found unresponsive in bed the following morning and pronounced dead at 1336 on January 9, 2021


VAERS ID: 934869 (history)  
Form: Version 2.0  
Age: 83.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-01-05
Onset:2021-01-06
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-01-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 026L20A / 1 LA / IM

Administered by: Senior Living       Purchased by: ?
Symptoms: Body temperature increased, Condition aggravated, Facial paralysis, Hemiparesis, Rash erythematous, SARS-CoV-2 test negative, Skin warm
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (narrow), Hearing impairment (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (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? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Prednisone 10mg, Donepezil HCL 10mg, Breo Ellipta inhaler, Spiriva Inhaler, Plavix
Current Illness: Rash, Non hemorrhagic CVA in 2009, Alzheimer''s dementia, COPD, HLD, CKD, Allergic Rhinitis
Preexisting Conditions: previous CVA, COPD, Alzheimer''s dementia
Allergies: none noted
Diagnostic Lab Data: Please see attached documentation
CDC Split Type:

Write-up: Patient had a rash prior to COVID vaccine. Prednisone 10mg started on 1/5/21 (only one dose administered) 1/6/21, 1am - Rash worsened with increase redness, warmth and extending of body surface, Temp 100.4, 1/6/21, 1:20am Benadryl 25mg administered, (Keflex was ordered at this time, however never administered). 1/6/21, 3am rash improved, temp 99.1 1/6/21, 6:50am Right facial droop and right sided weakness, sent to ER 1/6/21 transferred to hospital, continues to be hospitalized 1/11/2021


VAERS ID: 934901 (history)  
Form: Version 2.0  
Age: 92.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-01-08
Onset:2021-01-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-01-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 026L20A / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal pain
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? No
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: APAP, amlodipine, metoprolol, ramipril, spironolactone, dutasteride, vitamin B12,
Current Illness:
Preexisting Conditions: SCC, CHF, HTN, BPH, CARCINOMA OF COLON
Allergies: NKDA
Diagnostic Lab Data:
CDC Split Type:

Write-up: SEVERE ABDOMINAL PAIN


VAERS ID: 934990 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-01-07
Onset:2021-01-09
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-01-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 012L20A / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Contusion, Immunoglobulin therapy, Injection site pain, Platelet count decreased, Platelet transfusion
SMQs:, Haematopoietic thrombocytopenia (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Systemic lupus erythematosus (broad), Accidents and injuries (narrow), Extravasation events (injections, infusions and implants) (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? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Ibuprofen and acetaminophen
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: 1/9/2021 18:30 2x10^3/uL 1/9/2021 21:30 6x10^3/uL 1/10/2021 02:10 8x10^3/uL 1/10/2021 07:30 18x10^3/uL 1/10/2021 18:12 127x10^3/uL 1/11/2021 05:43 142x10^3/uL
CDC Split Type:

Write-up: 26-year-old lady came in after she noticed she had bruises on her left hand after a CPR procedure at hospital. Patient was apparently in well health, she had received COVID-19 mRNA vaccine on January 7 at 3 PM, she has taken 2 pills with ibuprofen and tylenol for pain in right deltoid following vaccination. She was doing the CPR at 1:00 this afternoon, and she noticed that her left dorsum had some bruises. She took day off and went home and noticed that she also had bruises in both medial thighs, above the knee and some bruises in scalp. Patient presented to the Emergency Room 1/9/2021 ~6PM and platelet count was found to be 2x10^3/uL. Patient required transfusion of 7 units of platelets, steroids, and IVIG.


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