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From the 9/17/2021 release of VAERS data:

Found 80,760 cases where Vaccine is COVID19 and Manufacturer is MODERNA and Standard-MedDRA-Query broadly-matches 'Anaphylactic reaction'



Case Details

This is page 3 out of 8,076

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VAERS ID: 907098 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Unknown  
Vaccinated:2020-12-22
Onset:2020-12-22
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2020-12-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011J20A / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Chills, Injection site erythema, Pruritus
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient received Moderna COVID vaccine at 1926. She completed standard 15 min observation time and was dismissed from clinic. Patient returned to clinic at 2000 with redness at injection site, itching, chills. BP 126/90 and pulse 86, patient able to speak comfortably. Diphenhydramine 25 mg given orally. Patient observed for 36 minutes. All symptoms resolved and observed redness to left deltoid completeely resolved. No complaints of shortness of breath or difficulty breathing. Patient discharged from clinic to another facility with appropriate follow up instructions. Patient texted ahead to her preceptor that she is en route.


VAERS ID: 907131 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Iowa  
Vaccinated:2020-12-22
Onset:2020-12-22
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2020-12-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025J20-2A / 1 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Palpitations, Pharyngeal swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Arrhythmia related investigations, signs and symptoms (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Cardiomyopathy (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? No
Previous Vaccinations:
Other Medications: Wellbutrin, Alprazolam (as needed), Loratadine, Omeprazole, Vitamin D, Calcium, Multivitamin
Current Illness: None known
Preexisting Conditions:
Allergies: Morphine, Strawberries, Prochlorperazine, Septra, Penicllin, Levaquin, Ciprofloxacin, Cephalexin, Ceftriaxone
Diagnostic Lab Data:
CDC Split Type:

Write-up: About 10-15 minutes after receiving vaccine patient reported that her heart began to race and throat began to swell.


VAERS ID: 907329 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Arizona  
Vaccinated:2020-12-22
Onset:2020-12-22
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2020-12-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011J20A / 1 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Abdominal discomfort, Dizziness, Dyspnoea, Hypoaesthesia, Tremor, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypoglycaemia (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: Meloxicam
Current Illness: Obesity Gastric Sleeve
Preexisting Conditions: None
Allergies: NKA
Diagnostic Lab Data: 12/22 ED administrated Lactated Ringers, Decadron 10mg, PEPCID, ZOFRAN,
CDC Split Type:

Write-up: Employee presented to COVID Clinic for Moderna COVID 19 vaccination 1st dose. Given to right arm. Left clinic after waiting 15 minute observation time. She returned to work and returned about 45 minutes reporting she was having difficulty taking deep breaths, numbness to bilateral extremities, abdominal discomfort and lightheaded, NO rash or hives noted. VSS stable A&O, Within a few minutes employee started vomiting, shaking, and C/O of severe abdominal discomfort, Epinephrine injection 0.5mg given to left arm. Employee transported to ED.


VAERS ID: 907330 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Arizona  
Vaccinated:2020-12-22
Onset:2020-12-22
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2020-12-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011J20A / 1 LA / SYR
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011J20A / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Abdominal discomfort, Abdominal pain, Dizziness, Dyspnoea, Headache, Hyperhidrosis, Hyperventilation, Rash macular, Tremor, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Parkinson-like events (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Hypersensitivity (narrow), 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? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Flexeril, Advil, Protonix, Estrace, Vivelle DOT Norco PRN
Current Illness: No
Preexisting Conditions: Mild Osteopenia, GERD, Anemia,
Allergies: Reglan - anaphylaxis
Diagnostic Lab Data: 12/22 ED administrated PEPCID, ZOFRAN, Prednisone 60 mg, and Ativan 1mg IV.
CDC Split Type:

Write-up: Employee presented to COVID Clinic for Moderna COVID 19 vaccination 1st dose. Given to left arm. Left clinic prior to completing 15 minute observation time and told an MA in waiting area that she felt ill ot her stomach and having trouble taking deep breaths. Employee found in nearby Bathroom sitting on the floor, she had vomited, reported she was lightheaded, couldn''t breath, shaking, abdominal discomfort sweating, attempted to move employee to wheelchair, did respond well to transfer to Wheelchair, She reported symptoms worsening: HA, abdominal pain and developed blotchy skin, hyperventilating, and dizzy. CODE Blue called, patient given Epinephrine injection 0.5mg patient sent to ER


VAERS ID: 907331 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Arizona  
Vaccinated:2020-12-22
Onset:2020-12-22
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2020-12-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011J20A / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Abdominal discomfort, Asthenia, Chest discomfort, Dizziness, Hypoaesthesia, Immediate post-injection reaction, Nausea, Palpitations, Rash macular
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Cetirizine, Advil,
Current Illness: No
Preexisting Conditions: ASTHMA
Allergies: NDKA
Diagnostic Lab Data: ED administrated methylprednisolone sodium succinate 125mg, Benadryl 50 mg, and Ativan 1mg IV.
CDC Split Type:

Write-up: Employee presented for COVID 19 vaccination: Survey reviewed, no history of Anaphylaxis reaction Moderna 1st dose given today to Left arm. She immediately developed Numbness to her body, chest tightness, and abdominal discomfort. Remained Alert and oriented, voiced concerned she felt like she was going to pass out. She developed blotchy skin to chest and neck area within minutes of injection. Patient sat in a wheelchair. Vital taken: BP 140/98 Pulse 123, given water to drink, tolerated well. She quickly reported she continued with above stated ymptoms, and continued with nausea, blotchy skin, heart racing and weakness. She was given 0.3mg of Epinephrine IM to right arm and taken to the ED


VAERS ID: 907254 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Connecticut  
Vaccinated:2020-12-23
Onset:2020-12-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2020-12-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011J20A / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Erythema, Injection site 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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Flu vaccine Flucelvax
Other Medications: Benadryl 50 mg po prior to vaccine
Current Illness: none
Preexisting Conditions: Thyroid disease Migraine Allergic rhinitis GERD (gastroesophageal reflux disease) Visual impairment
Allergies: Amoxicillin Penicillin Cefzil food and nut
Diagnostic Lab Data: Solumedrol 125 IM Pepcid 20 mg po
CDC Split Type:

Write-up: Approx 10 min after receiving vaccine- patient developed rash and hives on neck and chest with complaints of itchiness on R arm at vaccine site. Also developed redness to right ear. no respiratory difficulties noted. Patient transported to ED for further evaluation and treatment


VAERS ID: 907259 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Ohio  
Vaccinated:2020-12-23
Onset:2020-12-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2020-12-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025J20A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Pruritus, Skin irritation
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? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Influenza
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: flu vaccine gets itching
Diagnostic Lab Data:
CDC Split Type:

Write-up: Severe itching, irritation, took oral Benadryl, proceeded to nearest Emergency Room


VAERS ID: 907302 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Male  
Location: New York  
Vaccinated:2020-12-21
Onset:2020-12-22
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2020-12-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011J20A / 1 LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Chills, Chromaturia, Eye swelling, Fatigue, Headache, Myalgia, Nausea, Pain, Pyrexia, Rash
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (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? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: vit B,b12, finasteride, vascepa, Pepcid, Tylenol, naproxen, Benadryl, and androgel, MGUS ( autoimmune disorder)
Current Illness: none
Preexisting Conditions: low testosterone, high triglucerides
Allergies: none
Diagnostic Lab Data: none
CDC Split Type: vsafe

Write-up: 12/23@9:35am EST- Caller stated on12/22/20 at midnight he felt fever 103.0, chills, muscle soreness and aching, nausea and extreme fatigue. Caller called Primary and was told to take Tylenol 1gr. Benadryl and naproxen for headache and body aches. Rash covered arms , neck and thighs and patika on elbow and armpit. This morning rash is still prominent, eyes are swollen and urine is bright red. Caller is awaiting primary to call back.


VAERS ID: 907325 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Maine  
Vaccinated:2020-12-22
Onset:2020-12-22
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2020-12-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 039K20A / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chills, Dyspnoea, Headache, Nausea, Pain in extremity, Pyrexia, Sleep disorder
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (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? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Reported fever of 100.8, nausea, headache, chills, arm pain- which is common reported side effects of vaccine. Patient reported walking up in the middle of the nights gasping for air- short of breath. Only lasted 3 times during the night, no interventions were done. Went away on it''s own.


VAERS ID: 907347 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Delaware  
Vaccinated:2020-12-22
Onset:2020-12-23
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2020-12-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Dyspnoea, Fatigue, Headache, Myalgia, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (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: bupropion, certizin, omeprazole, paxil
Current Illness: none
Preexisting Conditions: asthma
Allergies: Penicillin, soy protein
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Muscle and joint pain, headache, vomiting (could be from the headache), fatigue, shortness of breath.


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