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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 23 out of 9,057

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VAERS ID: 910087 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Kansas  
Vaccinated:2020-12-22
Onset:2020-12-22
   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 / UNK LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Eye swelling, Hypoaesthesia, Hypoaesthesia eye, Swelling face, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Corneal disorders (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (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: Only Advair asthma inhaler 1 puff 2xs per day
Current Illness: NA
Preexisting Conditions: Asthma, environmental allergies (grasses, animal dander).
Allergies:
Diagnostic Lab Data: NA
CDC Split Type:

Write-up: Swelling and numbness around right eye and cheek; hives. Lasted for about 2 hours maximum. Took Claritin and showered.


VAERS ID: 910097 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: New York  
Vaccinated:2020-12-25
Onset:2020-12-25
   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: Private       Purchased by: ?
Symptoms: Dizziness, Fatigue, Loss of consciousness, Neck pain, Pain in extremity, Palpitations, Pyrexia, Rash, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypersensitivity (narrow), Arthritis (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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Migraines
Allergies: Sulfa
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Palpitations felt after 15-20 minutes, subsided within 15 minutes. Fatigue set in after 4-5 hours. Fever the following morning to 100.8 F. Fever accompanied with dizziness and lightheadedness, syncopal event with brief LOC. Overwhelming fatigue until 3:30 pm the following day, with arm pain. On day #3 arm pain persisted, new development of neck pain and mild truncal rash.


VAERS ID: 910120 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: New York  
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 011J20A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Dizziness, Flushing
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Vestibular disorders (broad), Hypersensitivity (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: unknown
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: NKA
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: facial flushing and dizziness experienced by the patient 10 minutes after administration.


VAERS ID: 910133 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: South Dakota  
Vaccinated:2020-12-23
Onset:2020-12-24
   Days after vaccination:1
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: Private       Purchased by: ?
Symptoms: C-reactive protein increased, Full blood count normal, Speech disorder, Swollen tongue, X-ray normal
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Dementia (broad), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (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? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Guaifenesin, Albuterol Inh, levothyroxine, amlodipine, coreg, Claritin.
Current Illness: none
Preexisting Conditions: Hypothyroidism, Hypertension, menopause
Allergies: environmental (sneezy/watery eyes), ibuprofen,
Diagnostic Lab Data: Labs completed at 1352. CBC WNL. CRP 7.4. Soft tissue neck xray at 1527 with no acute findings.
CDC Split Type:

Write-up: Noted tongue starting to swell on 12/24 at 1030. Started on left side, then progressed to right side. No SOB, difficulty swallowing or breathing, but staff noted difficulty understanding her speech. Presented to ED at 1300. 50mg Benadryl given IV on 12/24 at 1328 and 125mg solumedrol given IV at 1327. Pt reported improvement in tongue swelling at 1630.


VAERS ID: 910134 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Florida  
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 039K20A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Flushing, Hot flush, Nervousness
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad), Hypoglycaemia (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 88mcg daily po, Zoloft 25mg at bedtime po, Vit D3, Multi vitamin, and Fish Oil.
Current Illness: None
Preexisting Conditions: Hypothyroidism/Hashimoto''s Disease
Allergies: Sulfa.
Diagnostic Lab Data: None
CDC Split Type:

Write-up: 09:48am While waiting her wait time, reading emails, she felt flushed, like a "hot flash". Heart rate per her apple watch was 152. 09:54am Seated, placed on monitor for BP and O2 sat., 151/90, HR 111, 99% on room air. 10:05 158/87, 111, 99% - RA 10:10 147/85, 102, 100% - RA, States feeling nervous. 10:20 144/84, 96, 100% - RA, States feeling better, less nervous. No shortness of breath, no facial swelling. No other complaints. Allowed to leave facility. With instructions to follow up with Emergency Department if any life threatening symptoms develop and to follow up with Employee Health if needed. She verbalized understanding of above.


VAERS ID: 910135 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Michigan  
Vaccinated:2020-12-23
Onset:2020-12-26
   Days after vaccination:3
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: Pruritus, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: cozaar 100 mg, zoloft 100mg, albuterol prn, Combivent inhaler per 6 hrs, heart burn generic over the counter medication
Current Illness: 2 wks prior symtoms of covid; covid test-negative. Upper respiratory infection - asthma/allergies
Preexisting Conditions: asthma and allergies
Allergies: augmentin, demorol, Theo-Dur, slight latex allergy, melons, kiwi, avocado, banana, walnuts
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: 12/26/2020 2:00PM ears itching, hives - left wrist to elbow -- Urgent Care Visit -- Solumedrol shot received and Benadryl advised to take. Hives cleared on skin 12/26/2020


VAERS ID: 910154 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Iowa  
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 025J20-2A / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Lip swelling, Pruritus
SMQs:, Anaphylactic reaction (broad), Angioedema (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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: prescribed an Epi pen
CDC Split Type:

Write-up: Itchy and bottom lip felt swollen. Went to the ED.


VAERS ID: 910166 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Missouri  
Vaccinated:2020-12-21
Onset:2020-12-21
   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 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Erythema
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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: About 20 minutes after receiving the vaccine both hands turned flame red from the wrists to fingertips. No itching or burning. Resolved after about an hour.


VAERS ID: 910171 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: Missouri  
Vaccinated:2020-12-24
Onset:2020-12-24
   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 / UNK LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Throat tightness
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: blood pressure issues and tightness of throat


VAERS ID: 910179 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Montana  
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 037K20A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Flushing, Headache
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (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: None at time of report
CDC Split Type:

Write-up: Came to recovery area and within a period of 5 minutes or less complained of a headache. Face became flushed and was taken to lay down on stretcher. BP 142/80, HR 140, RR 20. Patient was given water, Ibuprofen 800mg and Benadryl 50 mg. BP 135/90, HR 78, SaO2 100% room air. Patient sat up and drank juice and ate granola bar. Patient left at 0925


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