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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 25 out of 9,057

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VAERS ID: 910266 (history)  
Form: Version 2.0  
Age: 76.0  
Sex: Male  
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 037K20A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood pressure increased, Decreased appetite, Dyspnoea, Fatigue, Heart rate increased, Nasal congestion, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Hypertension (narrow), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (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: unknown
Current Illness: unknown
Preexisting Conditions: unknown
Allergies: unknown
Diagnostic Lab Data: He was previously COVID positive in July 2020.
CDC Split Type:

Write-up: reported no s/s of adverse reaction at time of vaccination and for 30 minute post-vaccination monitoring period. States that approximately 4 hours after administration , he had elevated BP (148/92) and heart rate (115bpm). Normal readings are HR in the 60s-70s and "normal" BP 120/60s. Had fever of 102 the first night that lingered for 48 hours, accompanied by extreme fatigue, nasal congestion, shortness of breath, decreased appetite, He took tylenol for fever and afrin for nasal congestion. By the 26th, he felt well enough to get dressed. No fever, appetite back to normal. BP on the 26th was normal to low and heart rate 105. Adverse reactions required no further treatment.


VAERS ID: 910269 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: California  
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 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Abdominal pain upper, Chest discomfort, Cough, Dizziness, Dyspnoea, Fatigue, Feeling abnormal, Headache, Illness, Impaired work ability, Nausea, Pain, Paraesthesia oral, Pyrexia, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), 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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Levothyroxine 100 mcg
Current Illness: None
Preexisting Conditions: None
Allergies: Latex
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Assigned to work at nursing location. I reported for duty on 12/23/2020 @ 1310 and was offered the vaccine. No reaction at that time. Several hrs into my shift I became ill. Nausea, vomiting, trouble breathing, tongue was feeling funny, dizzy, stomach pain, extreme fatigue and lightheaded. I immediately reported to the charge nurse on the floor then shortly called my registry informing them of the current events. Registry offered to call 911 and I declined. Registry gave permission to end of shift and go home.. However when I notifed the charge nurse on the floor she stated I can''t leave because she was leaving for the day. She called supervisor. I spoke to him and explained the situation and he informed me another person whom was a MD also was experiencing the same symtpoms. He instructed me to stay in the room I was at and they will send orange juice it should make me feel better. I waited and waited. I called the sup back and informed him my symptoms are getting worse and need to go. At this time I had developed a severe headache. I was not able to continue with extremely HEAVY workload caring 29 COVID patients in my condition and sup allowed me to go home. He said he would talk to the floor nurse because he had already arranged for 2 nurses to come in 7 pm which was shortly. Once home, my husband said I had a blank stare and dazed. Several hrs later I developed a fever, cough and severe body pain. I remained in bed for several days and most symptoms resolved. However on the 4th day went out and within a few started to become short of breath and heaviness on my chest and attempted the following day going outside and the same thing. I continue to have intermittent stomach pains and coughing.


VAERS ID: 910331 (history)  
Form: Version 2.0  
Age: 47.0  
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 011J20A / UNK RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Dizziness, Hypertension, Swelling face, Tachycardia, Throat irritation
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypertension (narrow), Vestibular disorders (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (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: levothyroxine 112mcg, pepcid, benadryl
Current Illness: nonesm,
Preexisting Conditions: hypothyroidism, elevated ANA level- unknown cause rheumatology evaluated in February
Allergies: nka
Diagnostic Lab Data:
CDC Split Type:

Write-up: 0654 TACHYCARDIA. LIGHTHEADED, THROAT IRRITATION, HYPERTENSION, & FACIAL SWELLING


VAERS ID: 910344 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Unknown  
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 011J20A / 1 AR / IM

Administered by: Work       Purchased by: ?
Symptoms: Dyspnoea, Flushing
SMQs:, Anaphylactic reaction (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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None.
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Difficulty breathing, catching breath then face flushing an hour after vaccination. She took her temp which was normal, went to sleep and woke up the next day feeling fine. No history of asthma or COPD. No history of AE from vaccines in the past.


VAERS ID: 910345 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Wisconsin  
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 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Pruritus
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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Flu
Other Medications: Fiber gummies Probiotic MVI Pepcid Hyomax SR Cherry tart drop
Current Illness: Gastritis
Preexisting Conditions: Gastritis
Allergies: Flu vaccine Protonix Nexium Sulfa Any narcotic
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Overall itchiness


VAERS ID: 910363 (history)  
Form: Version 2.0  
Age: 84.0  
Sex: Male  
Location: California  
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 LOT 039K20A / 1 RA / IM

Administered by: Senior Living       Purchased by: ?
Symptoms: Death, Hypophagia, Hypotension, Somnolence
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypoglycaemia (broad), Dehydration (broad), Hypokalaemia (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2020-12-28
   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: risperidone daily doxazosin
Current Illness: dementia declining oral intake
Preexisting Conditions: history of aspiration pneumonia BPH
Allergies: none
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Patient had mild hypotension, decreased oral intake, somnolence starting 3 days after vaccination and death 5 days after administration. He did have advanced dementia and was hospice eligible based on history of aspiration pneumonia.


VAERS ID: 910364 (history)  
Form: Version 2.0  
Age: 30.0  
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 - / 1 - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Chest discomfort, Fatigue, Hypoxia
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Eosinophilic pneumonia (broad), Respiratory failure (broad), Infective pneumonia (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: pt co fatigue over the weekend and then developed chest pressure and hypoxia per pt on 12/28/20


VAERS ID: 910365 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Florida  
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 / SYR

Administered by: Other       Purchased by: ?
Symptoms: Axillary mass, Axillary pain, Body temperature increased, Bone pain, Chills, Crying, Headache, Musculoskeletal stiffness, Nausea, Neck mass, Oral herpes, Pain, Pain in extremity, Pruritus, Tenderness, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Dystonia (broad), Parkinson-like events (broad), Oropharyngeal infections (narrow), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Depression (excl suicide and self injury) (broad), Osteonecrosis (broad), Hypersensitivity (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Opportunistic infections (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: none
Allergies: none
Diagnostic Lab Data: none
CDC Split Type:

Write-up: The sequence of events begins approx. 3:30pm on 12/23/20. 12/23/20 ? headache, nausea with vomiting, brief itching, chilled feeling, temp of 99.9, body/bone aches all over with legs hurting the most, very sore injection arm, husband and I debated on going to the ER, cried 12/24/20- headache, nausea without vomiting, body/bone aches, didn?t take temp, sore arm. 12/25/20- same as 12/24 12/26/20-body/bone aches but not as intense, headache, arm sore, neck was tad stiff. When I put on deodorant it hurt then felt pea sized lump painful to touch in left arm pit. Also felt lump on left side on my neck the size of thumb pad but not painful. Cold sore appeared on bottom lip 12/27/20- sore armpit- lump smaller, neck lump smaller non painful, nauseous 12/28/20-armpit feeling better lump almost gone still painful if I press on it otherwise not an issue, neck lump smaller -pinky pad finger size non painful June 2020 tested positive for COVID was moderate in symptoms


VAERS ID: 910366 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Missouri  
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 / UNK RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Pruritus, Rash, 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? 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:
CDC Split Type:

Write-up: Less than 15 minutes after vaccination alerted lead of itching and hives. Noted rash. Has had similar reactions to medications in the past. No respiratory compromise. Per standing order was given Benadryl 50mg po with water at 1519. 1520 VS: 158/79-82-16-96.9 and 96% on room air. 1534 VS: 140/73-76-16-96.6 and 95% on room air. Employee was observed for an additional 15 minutes with no progression of symptoms. Instructed to call lead if any further symptoms develop. Returned to lab department to work.


VAERS ID: 910368 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: Ohio  
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 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Nausea, Periorbital swelling, Retching, Throat clearing, Throat irritation
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Periorbital and eyelid disorders (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: Vitamin D3, celexa, omeprazole, singulair
Current Illness: none
Preexisting Conditions: osteopenia, GERD, depression, hypothyroidism, PMH of uterine cancer (2008
Allergies: acetaminophen, erythromycin, azithromax
Diagnostic Lab Data: none
CDC Split Type:

Write-up: patient became nauseated and began dry heaving. C/o "tickle in back of throat" with repetitive throat clearing. Mild periorbital swelling noted Given Zofran, Pepcid, Benadryl, epi-pen x 1, IV initiated EMS took patient to emergency department for further evaluation


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