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From the 1/14/2022 release of VAERS data:

Found 6,789 cases where Vaccine is COVID19 and Manufacturer is MODERNA and Symptom is Cerebral venous sinus thrombosis or Cerebral venous thrombosis or Coagulopathy or Deep vein thrombosis or Disseminated intravascular coagulation or Embolism or Idiopathic thrombocytopenic purpura or Immune thrombocytopenia or Immune thrombocytopenic purpura or Ischaemic stroke or Myocardial infarction or Petechiae or Pulmonary embolism or Purpura or Thrombocytopenia or Thrombosis or Vasculitis

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Case Details

This is page 33 out of 679

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VAERS ID: 1069054 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: New York  
Vaccinated:2021-01-14
Onset:2021-01-16
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-03-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Anxiety, Fatigue, Thrombosis, Ultrasound scan
SMQs:, Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (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? No
Previous Vaccinations:
Other Medications: VITAMIN D NOS; MAGNESIUM; LISINOPRIL; VITAMIN B12 NOS
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: No adverse event (No medical history reported.)
Allergies:
Diagnostic Lab Data: Test Date: 20210116; Test Name: Ultrasound; Result Unstructured Data: Blood clots in her left leg, her right leg and her brain
CDC Split Type: USMODERNATX, INC.MOD20210

Write-up: Anxious; Tired; Blood clots in left leg, right leg and brain; A spontaneous report was received from a consumer who was also a 66-year-old female patient, who received Moderna''s COVID-19 vaccine (mRNA-1273) and developed blood clots in the left leg, right leg, and brain, anxious and tired. The patient''s medical history was not provided. Concomitant medications reported included vitamin D, magnesium, lisinopril, and vitamin B12. On 14 Jan 2021, approximately 3 days prior to the onset of symptoms, the patient received their first of two planned doses of mRNA-1273 (Batch number not provided) intramuscularly in the left deltoid for prophylaxis of COVID-19 infection. On 16 Jan 2021, the patient experienced immense pain in the middle of the night, and subsequently saw her primary physician. An ultrasound revealed blood clots in her left leg, right leg and brain. A hematologist and vascular surgeon were consulted. Patient was treated with apixaban while they are doing blood work. The patient also became tired and anxious. She noted that she never had comorbidities before and was upset that her life has completely changed. A repeat ultrasound was scheduled for 19 Feb 2021. The mRNA-1273 dose was discontinued in response to the event of blood clots in the left leg, right leg, and brain, anxious and tiered. The outcome of events, blood clots in the left leg, right leg, and brain was considered unknown at the time of this report. The outcome of the events, tired and anxious were considered not resolved at the time of this report.; Reporter''s Comments: Very limited information regarding the events has been provided at this time. Further information has been requested.


VAERS ID: 1070595 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: Louisiana  
Vaccinated:2021-02-17
Onset:2021-02-24
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-03-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 031M20A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Antinuclear antibody, Blood thyroid stimulating hormone, Complement factor normal, Contusion, Differential white blood cell count normal, Electrophoresis protein normal, Fatigue, HIV test negative, Haematocrit normal, Haemoglobin normal, Helicobacter test negative, Hepatitis B test negative, Hepatitis C test negative, Immune thrombocytopenia, Immunoglobulins normal, Oral herpes, Petechiae, Platelet count decreased, Respiratory viral panel, Rheumatoid factor, SARS-CoV-2 test negative, Vitamin B12 normal, White blood cell count normal
SMQs:, Haematopoietic thrombocytopenia (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Systemic lupus erythematosus (broad), Oropharyngeal infections (narrow), Accidents and injuries (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (narrow), COVID-19 (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, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: amlodipine Breo ellipta
Current Illness: n/a
Preexisting Conditions: ? Hypertension ? Mild asthma ? Osteoarthritis of multiple joints
Allergies: Glyceryl-t, Nickel, Pcn [Penicillins]
Diagnostic Lab Data: 2/27/2021: covid and respiratory viral panel negative; hiv/hep B/C negative; vitamin B12 normal; H pylori negative; SPEP and immunoglobulins normal; TSH 0.33; normal WBC and hemoglobin/hematocrit with normal differential; normal rheumatologic workup with ANA profile and complement normal
CDC Split Type:

Write-up: acute ITP, platelet count 2,000 with petechial rash, bruising, fatigue, herpes labialis simplex one - petechia occurred 7 days post vaccine; hospitalization 9 days post vaccine. responded to steroids and normalized platelet count 180,000 14 days post vaccine


VAERS ID: 1293725 (history)  
Form: Version 2.0  
Age: 87.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-02-10
Onset:2021-02-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Platelet count decreased, Thrombocytopenia
SMQs:, Haematopoietic thrombocytopenia (narrow), Systemic lupus erythematosus (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? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Narrative:


VAERS ID: 1071123 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-01-25
Onset:2021-02-13
   Days after vaccination:19
Submitted: 0000-00-00
Entered: 2021-03-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Myocardial infarction, Stent placement
SMQs:, Myocardial infarction (narrow), Embolic and thrombotic events, arterial (narrow)

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, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: No adverse event (No medical history reported)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20210

Write-up: minor heart attack; stent put in; A spontaneous report was received from a consumer who was also a 75 year old female patient who received Moderna''s COVID-19 Vaccine (mRNA-1273) and experienced a minor heart attack / myocardial infarction and stent was put in / stent placement. The patient''s medical history was not provided. No relevant concomitant medications were reported. On 25-Jan-2021, prior to the onset of the events, the patient received their first of two planned doses of mRNA-1273 in the left arm for prophylaxis of COVID-19 infection. On 13-Feb-2021, the patient experienced a minor heart attack and had a stent placement. Action taken with mRNA-1273 in response to the event was not reported. The outcome of the events, minor heart attack and stent was put in, was not provided.; Reporter''s Comments: Very limited information regarding the events has been provided at this time. Further information has been requested.


VAERS ID: 1071396 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Male  
Location: South Carolina  
Vaccinated:2021-02-19
Onset:2021-02-27
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-03-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Angiogram, Deep vein thrombosis, Echocardiogram, Pulmonary embolism, Ultrasound Doppler
SMQs:, Embolic and thrombotic events, venous (narrow), Thrombophlebitis (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, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: rosuvastatin 10 mg., olmesartan 20-12.5 mg., Vitamin C and D3, omega 3 supplement, CoQ10.
Current Illness: None known
Preexisting Conditions: Hypertension and hyperlipidemia
Allergies: None known
Diagnostic Lab Data: Ultrasound Peripheral Venous Leg Unilateral, CT Angiography Chest, Transthoracic Echocardiogram
CDC Split Type:

Write-up: ER admission on February 27th, discharged with a diagnosis of Bilateral Pulmonary Embolism and DVT of lower limb


VAERS ID: 1072189 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-02-15
Onset:2021-02-16
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-03-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 031L20A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Back pain, Cold sweat, Cough, Feeling cold, Hyperhidrosis, Intensive care, Magnetic resonance imaging thoracic abnormal, Nausea, Pain, Pulmonary embolism, Thrombosis
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Retroperitoneal fibrosis (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypoglycaemia (broad)

Life Threatening? Yes
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: Placid and vitamin D3
Current Illness: None
Preexisting Conditions: June 28 2020, insertion of stents into left femoral artery and popliteal behind knee cap.
Allergies: None
Diagnostic Lab Data: ER 2/20-2/21 MRIs showed a spray of blood clots in both lung lobes. Was admitted to ICU till release 02/23 pm. Pulmonary Embolisms on Epixaban, azithromycic and cefpodoxime
CDC Split Type:

Write-up: Started dry cough for three day, pain across the lower back began two days after cough. Began intense pain with nausea and cold and clammy sweats. Called the nurse on my insurance who advised to get to the ER.


VAERS ID: 1072530 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Washington  
Vaccinated:2021-01-25
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2021-03-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 042L20A / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Platelet count decreased, Thrombocytopenia
SMQs:, Haematopoietic thrombocytopenia (narrow), Systemic lupus erythematosus (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? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: No adverse event (No reported medical history)
Allergies:
Diagnostic Lab Data: Test Date: 2021; Test Name: Platelets dropped down to 2; Result Unstructured Data: Decreased tp 2
CDC Split Type: USMODERNATX, INC.MOD20210

Write-up: Thrombocytopenia; A spontaneous report was received from a NURSE, concerning a 74-Years-old male patient who received Moderna''s COVID-19 vaccine (mRNA-1273) and experienced thrombocytopenia. The patient''s medical history was not provided. No relevant concomitant medications were reported. On 25-Jan-2021, prior to the onset of the events, the patient received their first planned dose of mRNA-1273 (lot/batch: 042L20A) for COVID-19 infection prophylaxis. On an unspecified date in 2021, the patient experienced the event thrombocytopenia and presented to emergency room and was hospitalisation on an unspecified date in 2021. His platelets dropped down to 2. The event was also considered to be medically significant. No treatment information was provided. Action taken with mRNA-1273 in response to the event was not reported. The outcome of event was considered unknown. The reporter assessed the event thrombocytopenia as related to study drug.; Reporter''s Comments: Very limited information regarding this event of thrombocytopenia has been provided at this time. onset date of event, patient''s medical history full blood count results with reference ranges are lacking. Further information has been requested.


VAERS ID: 1072810 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-01-01
Onset:2021-01-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Catheter directed thrombolysis, Computerised tomogram thorax abnormal, Dyspnoea, Hypertension, Intensive care, Pulmonary embolism
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Hypertension (narrow), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unsure
Current Illness: Unsure
Preexisting Conditions: Unsure
Allergies: Unsure
Diagnostic Lab Data: see attached
CDC Split Type:

Write-up: SOB and HTN on 1/30/21, 3 wks after 1st Covid shot. Submassive acute saddle pulmonary embolism. Pt was sent by ambulance to ER. On arrival, CT revealed a saddle embolism. Heparin was initiated and pt was transported to hospital. Admitted to ICU and bil thrombolytic catheters were placed. On 1/31/21 thrombosis has dissolved. on cessation of thrombolysis and removal of lytic stents on 1/31/21 pt was placed on Xarelto. Pt was D/C on 2/1/21.


VAERS ID: 1073173 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Female  
Location: Iowa  
Vaccinated:2021-02-04
Onset:2021-02-10
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-03-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / -

Administered by: Private       Purchased by: ?
Symptoms: Blood creatinine increased, Blood culture positive, Blood lactic acid decreased, Blood phosphorus, Blood phosphorus decreased, Blood urea normal, Body temperature increased, COVID-19, Chest X-ray normal, Chills, Computerised tomogram thorax abnormal, Cough, Diarrhoea, Dysphonia, Dyspnoea, Electrocardiogram abnormal, Hilar lymphadenopathy, Lymphadenopathy mediastinal, Nasopharyngitis, Oxygen saturation decreased, Pneumonitis, Pulmonary embolism, SARS-CoV-2 test positive, Tachypnoea, Upper-airway cough syndrome
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (broad), Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Interstitial lung disease (narrow), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Embolic and thrombotic events, venous (narrow), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (narrow), Chronic kidney disease (broad), Hypersensitivity (broad), Noninfectious diarrhoea (narrow), Tumour lysis syndrome (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (narrow), Infective pneumonia (broad), Sepsis (broad), Opportunistic infections (broad), COVID-19 (narrow)

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, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Acetaminophen 650 mg PO Q8h PRN Amlodipine 10 mg PO QD Ascorbic acid 500 mg PO BID Cholecalciferol 1000 mg PO QD Dapagliflozin 5 mg PO QD Furosemide 20 mg PO QD Guaifenesin 1200 mg ER PO Q12h PRN Irbesartan 300 mg PO QD Metformin 500 mg PO
Current Illness:
Preexisting Conditions: Diabetes mellitus
Allergies: NKA
Diagnostic Lab Data: Please see above
CDC Split Type:

Write-up: Moderna COVID-19 Vaccine EUA 2/27/21: Pt received 1st Moderna vaccine 2/4/2021. She states that her symptoms 1st started out as a slight postnasal drip, which turned into a hoarse voice with a cough, which turned into a head cold, which has turned in due shortness of breath, diarrhea, and cough with associated chills. After 17 days of cold-like symptoms, pt was tested on 2/26 for COVID and tested positive. 2/27, pt worsened and presented to ED. Upon arrival to the emergency department, the patient''s temperature is 100.2� F, heart rate 96, respiratory rate 24, saturating 84% on room air with blood pressure 164/84. The patient''s laboratory studies were significant for BUN 17, CR 1.47, lactate 2.2, D-dimer 6.79, and phosphorus 2.2. The patient''s chest x-ray showed no acute findings. CT chest showed extensive acute bilateral pulmonary emboli involving most of the lobar and segmental branches, right greater than left with no saddle embolus. Findings borderline for right heart strain, correlate with echocardiogram. Peripheral ground-glass airspace opacities consistent with atypical/viral pneumonitis. Reactive mediastinal and hilar lymphadenopathy. EKG showed normal sinus rhythm, heart rate 93 with inferior infarct-age undetermined. The patient was administered 1 L IV NS, ceftriaxone 1 g IV, azithromycin 500 mg IV, and heparin IV bolus and drip for PE indication. Remdesivir started. 2/28/21: Pt on 3 L oxygen. Azithromycin, ceftriaxone, remdesivir continued. Vancomycin started. 3/1/21: 1 L oxygen via nasal cannula. Small, nonproductive cough. Pt complains of SOB. 3/2/21: 1/2 blood cultures from 2/27 positive for CoNS. Vancomycin discontinued. Pt feeling much better. Still on 1 L oxygen via nasal cannula. More alert. 3/3: 5 day remdesivir course and azithromycin, ceftriaxone course completed. Patient weaned off oxygen. Pt discharged home with oxygen as a precaution. Pt also enrolled in COVID Safe At Home telehealth program.


VAERS ID: 1073412 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-02-23
Onset:2021-02-24
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-03-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 013M20A / 2 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Catheter placement, Cerebrovascular accident, Coma, Computerised tomogram, Influenza like illness, Laboratory test, Magnetic resonance imaging, Pyrexia, Thrombosis, Ultrasound scan
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (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, 6 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Gummy vitamins
Current Illness: None
Preexisting Conditions: None
Allergies: Sulfur
Diagnostic Lab Data: Hospital has. Includes multiple CAT scans, MRIs ultrasounds and extensive lab work
CDC Split Type:

Write-up: Initial flulike symptoms with fever Tues -Friday. Had a right side stroke 6 AM Saturday morning . Rushed to hospital and had a procedure involving a catheter through the body to the clot in the brain. Came out of that with a weekend left side and was medicated through Sunday night. At 10:30 PM Sunday night had a second stroke on the right side. Did not wake from that. Now I?m not expected to survive.


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