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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 24 out of 9,057

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VAERS ID: 910188 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: West Virginia  
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 039K20A / 1 RA / IM

Administered by: Senior Living       Purchased by: ?
Symptoms: Erythema, 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? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: At 11:20AM Patient returned to vaccination room to show that she had developed hives on the right side of body (back, side, and legs). Patient was experiencing redness and itching--no shortness of breath. Patient was given 25mg of diphenhydramine. At 12:30PM Patient returned to show that the rash had cleared considerably and was not having any other issues. Patient was instructed to be observed by a healthcare provider for 30 minutes, rather than 15, for her second dose.


VAERS ID: 910190 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Nebraska  
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 LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Cough, Eye swelling, Headache, Impaired work ability, Lacrimation increased, Nausea, Rhinorrhoea, SARS-CoV-2 test, Sneezing, Swelling face, Throat irritation
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (broad), Angioedema (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Lacrimal disorders (narrow), 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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Migraines
Allergies: Penicillin; cephlosporins
Diagnostic Lab Data: Covid 19 swab- just to be on the safe side. Swabbed at Test at 0930 on 12/28/2020.
CDC Split Type:

Write-up: At 6 hours post vaccine (1400 on 12/26/2020), I woke up from a sound sleep sneezing convulsively and experiencing a headache, nausea, and extremely runny (literally gushing) nose and eyes. Within several hours, I also experienced swollen eyes and face as well as scratchy throat and slight cough. No effect: ibuprofen; ibuprofen; phenylephrine; loratadine; fexofenadine Effective: benadryl 100mg. q6hr(I was unable to take this previously because it puts me to sleep; once I was pulled from the work schedule I was able to take this) I have now taken three doses of 100 mg- as it wears off, some of the symptoms return, but they are gradually lessening. Since I am an RN, I am comfortable doing home treatment with my employer/employee health representative aware of the situation.


VAERS ID: 910193 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Massachusetts  
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 025J20A / 1 LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Chest pain, Dyspnoea
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (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: sulfa
Diagnostic Lab Data:
CDC Split Type:

Write-up: The patient reports developing CP and SOB about 1 hour after receiving the vaccination which resolved within 3-4 minutes. The patient denies seeking medical treatment and these symptoms were reported to employee health on 12/28/2020.


VAERS ID: 910215 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Wisconsin  
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 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Pain, 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? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: omeprazole
Current Illness: COVID19 in October
Preexisting Conditions: asthma and acid reflux
Allergies: sulfa antibiotics
Diagnostic Lab Data: none
CDC Split Type:

Write-up: 24 hours after vaccine woke up with significant body aches. Then rash started on left forearm and wrist. Following day it spread to right arm and back.


VAERS ID: 910218 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Nebraska  
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 - / UNK - / -

Administered by: Work       Purchased by: ?
Symptoms: Contusion, Dyspnoea, Injection site rash, Pain in extremity, Rash, Rash erythematous, Rash pruritic
SMQs:, Anaphylactic reaction (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Accidents and injuries (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow), 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? No
Hospitalized? No
Previous Vaccinations: Pneumomia Shoot 4 yrs ago
Other Medications: Lexapro
Current Illness: no
Preexisting Conditions: no
Allergies: no
Diagnostic Lab Data: no just called er and I took benadry and predisone.
CDC Split Type:

Write-up: later that night at home about 6:15 I stared to get a red rash across my chest and on to my left arm and was very itchy, then was hard to take deep breaths. I also got a pretty good size bruise on arm I got the shot in and arm was sore for 2 days. I also had lil bit of rash around where shot was.


VAERS ID: 910244 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: Massachusetts  
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 025J20A / 1 RA / IM

Administered by: Work       Purchased by: ?
Symptoms: Cough, Headache, Pain, Rhinorrhoea
SMQs:, Anaphylactic reaction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: tree nuts
Diagnostic Lab Data:
CDC Split Type:

Write-up: the patient developed symptoms 3 days later which included body aches, headache, cough, runny nose. pt is seeking her pcp for further testing/workup.


VAERS ID: 910249 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Unknown  
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 025J20A / 1 RA / IM

Administered by: Work       Purchased by: ?
Symptoms: Body temperature increased, Cough, Diarrhoea, Malaise, Pain
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (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? No
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: patient developed general malaise, body aches, cough, and diarrhea, temperature 99-100 F. Sought out pcp for testing/workup.


VAERS ID: 910254 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Pennsylvania  
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 1ST / 1 LA / SYR

Administered by: Military       Purchased by: ?
Symptoms: Cough, Headache, Hyperaesthesia teeth, Oropharyngeal pain, Pain, Rhinorrhoea
SMQs:, Anaphylactic reaction (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (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? No
Previous Vaccinations:
Other Medications: amoxicillin and clavulanate potassium 875mg/125mg take one two times daily metformin 3 x daily 500ml albuterol sulfate inhalation aerosol two every 6 hours as needed
Current Illness: recovering from pneumonia caused by covid 19. covid symtoms started 11/ 11/2020
Preexisting Conditions: diabetes high blood pressure air resistance
Allergies: shrimp
Diagnostic Lab Data: none
CDC Split Type:

Write-up: cough got worse runny nose headache sore throat chills body aches teeth sensitive all these symptoms started Wednesday night which is the day I got the vaccine they lasted all Thursday and felt nothing on Friday


VAERS ID: 910263 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: New Hampshire  
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, Hypoaesthesia, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Peripheral neuropathy (broad), Guillain-Barre syndrome (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? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: no allergies prior to moderna vaccine
Diagnostic Lab Data:
CDC Split Type:

Write-up: FLUSHING, HIVES, FACIAL NUMBNESS ON THE LEFT SIDE


VAERS ID: 910265 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Mississippi  
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 037K20A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Body temperature increased, Erythema, Injection site pain, Nausea, Urticaria
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (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:
Current Illness:
Preexisting Conditions: Hypertension, DM, hypothyroid
Allergies: NKDA
Diagnostic Lab Data: none
CDC Split Type:

Write-up: about 3 hours after injection, began feeling nauseous. the next day at about 8 am temp went up to 102.4. took ibuprofen and temp finally broke about 4 pm that day. had injection site soreness for the first 48 hours then developed large red wheal that covered 3/4 of upper arm. still with red area when this report was filed on 12/28/2020


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