National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

From the 10/8/2021 release of VAERS data:

Found 27,959 cases where Vaccine targets COVID-19 (COVID19) and Manufacturer is MODERNA and Serious



Case Details

This is page 4 out of 2,796

Result pages: prev   1 2 3 4 5 6 7 8 9 10 11 12 13   next


VAERS ID: 914309 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Arizona  
Vaccinated:2020-12-29
Onset:2020-12-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2020-12-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011J20A / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Dry throat, Flushing, Heart rate increased, Obstructive airways disorder, Oropharyngeal pain
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Dehydration (broad)

Life Threatening? Yes
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: Excedrin Migraine at 9:00 PM on 12/28/2020
Current Illness: None
Preexisting Conditions: History of allergies and anaphylaxis to raw produce
Allergies: Anaphylaxis to bananas, avocados and raw produce
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Within 3 minutes of vaccination patient became fully flushed head and neck, with rapid heart rate (112), and feeling like her airways were tightening.. Nurse immediately called for response, administered Epipen, when response arrived applied oxygen and transported to ED. Solumedrol 125 mg, Bendadryl 25 mg, and Famotidine 20 mg, she responded well and was released home with Rx Prednisone 40 mg x 3 days. Only residual effect was a dry/sore throat.


VAERS ID: 914392 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Ohio  
Vaccinated:2020-12-23
Onset:2020-12-30
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2020-12-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011J20A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Angioedema, Asymptomatic COVID-19, Blood creatine phosphokinase normal, Enlarged uvula, Erythema, Exposure to SARS-CoV-2, Feeling hot, Full blood count normal, Lip swelling, Liver function test normal, Metabolic function test normal, Pain in extremity, Quarantine, Rash, Rash erythematous, SARS-CoV-2 test positive, Swelling face, Throat tightness
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? Yes
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: Metformin, lisinopril. HCTZ, zetia, atorvastatin, KCL, baby aspirin, vitamin D, melatonin, B12, Nexium, vitamin E, ceterizine
Current Illness: Was covid negative 12/23. Tested covid positive 12/26. No symptoms of covid. (Husband has work exposure and had tested positive 12/23) we have quarentined since 12/23
Preexisting Conditions: diabetes, hypertension, elevated cholesterol, elevated liver enzymes, GERD
Allergies: None
Diagnostic Lab Data: 9:35am took Benadryl 50mg po, went to ED (arrived about 10am). had improved swelling and rash at 10:am. Physician reported uvula swollen. Received decadron 8mg po, Racemic epi nebulizer, IV fluid Lactated ringers. Labwork CBC, BMP , CK, Liver panel reported to me "normal". Improved and dismissed from ED 12noon 12/30.
CDC Split Type:

Write-up: 12/30 9:30 am developed angioedema. Swelling of face, lips, tight throat. Also had bright red rash over body trunk and arms. Both palms were red, hot and painful.


VAERS ID: 914473 (history)  
Form: Version 2.0  
Age: 83.0  
Sex: Female  
Location: Missouri  
Vaccinated:2020-12-28
Onset:2020-12-29
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2020-12-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025J20A / 1 RA / IM

Administered by: Senior Living       Purchased by: ?
Symptoms: Asthenia, Chest X-ray, Cognitive disorder, Computerised tomogram head, Decreased appetite, Depressed level of consciousness, Facial paralysis, Fatigue, Hypertension, Laboratory test, Livedo reticularis, Mental status changes, Pyrexia, Rash, Rash macular, Speech disorder, Tremor
SMQs:, Anaphylactic reaction (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Parkinson-like events (broad), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypertension (narrow), Cardiomyopathy (broad), Hearing impairment (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Eliquis, carbidopa-levidopa, Cardizem, Comtan, gabapentin, metoprolol, omeprazole, potassium citrate
Current Illness: COVID-19 positive
Preexisting Conditions: hypertension, hypokalemia, malignant neoplasm, tremor,
Allergies: Cipro, Levaquin, topiramate
Diagnostic Lab Data: Lab, Chest x-ray, Head CT, IVF
CDC Split Type:

Write-up: Weakness, fatigue, decreased appetite, upper extremity shaking, sternal red blotchy rash, decreased mental status, non-verbal, decreased level of conscious, mottling, left side facial droop, hypertensive, fever, unable to follow commands


VAERS ID: 914479 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: New York  
Vaccinated:2020-12-24
Onset:2020-12-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2020-12-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011J20A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Fatigue, Hemiparesis
SMQs:, Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Noninfectious encephalitis (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (narrow)

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: Xyzal 5mg tab. Take 1 tab BID Amlodipine 10mg 1 tab PO QAM Kariva (Mircette) 1 tab PO QHS Mucinex (Guaifenesin) 600 mg 1tab PO BID Omega 3 Fatty acid 1cap PO QD Calcium + Vitamin D 600 mg 2 tabs PO Qhs Ocean spray BID to nostrils Nas
Current Illness: none
Preexisting Conditions: Mild to moderate Intellectual Disabilities Organic Anxiety Disorder Atypical Manic Disorder Frontal Lobe Disorder Chronic Bronchiectasis Hypothyroidism Mild sleep apnea CPAP at 6 cm Hyperlipidemia Hypertension Nasal Allergies Facial Acne Obesity , Short Stature Chronic Sinusitis Seizure Disorder
Allergies: NKA
Diagnostic Lab Data:
CDC Split Type:

Write-up: Left sided weakness, fatigue for 3 days post immunization. Patient was seen by health care provider on 12/30/2020. Provider transferred patient to Hospital ER for further evaluation.


VAERS ID: 914521 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Idaho  
Vaccinated:2020-12-28
Onset:2020-12-29
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2020-12-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025J20-2A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain, Amphetamines positive, Anterograde amnesia, Antidepressant drug level, Atelectasis, Back pain, Bacterial test positive, Barbiturates positive, Blood culture, Blood lactic acid normal, Blood urine present, Chills, Cholelithiasis, Chromaturia, Coma scale abnormal, Computerised tomogram abdomen normal, Computerised tomogram head normal, Computerised tomogram pelvis, Computerised tomogram thorax normal, Condition aggravated, Cough, Culture urine, Drug screen, Dysarthria, Dysuria, Eye movement disorder, Flank pain, Gaze palsy, Glucose urine absent, Headache, Hypertonia, Hypopnoea, Incoherent, Influenza A virus test negative, Influenza B virus test, Influenza virus test negative, Intervertebral disc degeneration, Lethargy, Leukocytosis, Mental status changes, Migraine, Moaning, Myalgia, Nasal congestion, Nasal septum deviation, Nausea, Nitrite urine absent, Opiates negative, Oropharyngeal pain, Paranasal cyst, Pelvic pain, Protein urine absent, Pyrexia, Red blood cells urine negative, SARS-CoV-2 test positive, Scan with contrast normal, Seizure, Sinus disorder, Specific gravity urine normal, Unresponsive to stimuli, Urine abnormality, Urine analysis, Urine bilirubin decreased, Urine ketone body present, Urine leukocyte esterase, Urobilinogen urine, Vomiting, White blood cells urine negative, pH urine normal
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhage laboratory terms (narrow), Hyperglycaemia/new onset diabetes mellitus (narrow), Neuroleptic malignant syndrome (narrow), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Convulsions (narrow), Parkinson-like events (narrow), Drug abuse and dependence (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (narrow), Psychosis and psychotic disorders (broad), Gallbladder related disorders (narrow), Gallstone related disorders (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Ocular motility disorders (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Proteinuria (broad), Respiratory failure (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (narrow), Hypoglycaemia (broad), Infective pneumonia (broad), Hypokalaemia (broad), Opportunistic infections (broad), COVID-19 (narrow), 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? No
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: none on file
Current Illness: COVID- 19 diagnosis 12/11/2020 asymptomatic
Preexisting Conditions: DIAGNOSIS 1. COVID-19 virus infection ? 2. Urinary tract infection with hematuria, site unspecified ? ? Microscopic hematuria. 3. Seizure (HCC) ? 4. Nonintractable headache, unspecified chronicity pattern, unspecified headache type ? 5. Cough ? 6. Neutrophilic leukocytosis ? 7. Amphetamine or stimulant drug abuse (HCC) ? 8. Intracranial aneurysm ? ? Reportedly identified on MRI/MRA of brain in 2020. Unknown location, size, and characteristics. ? HX: seizures
Allergies: NKDA
Diagnostic Lab Data: Results as of 12/30/2020 14:32 12/30/2020 00:23 Color Urine: Yellow Clarity Urine: Slightly Cloudy (A) Specific Gravity: 1.010 Glucose Urine: Negative Bilirubin Urine: Negative Ketones Urine: 5 mg/dL Blood Urine: Moderate (2+) (A) pH Urine: 6.5 Protein Urine: Negative Nitrite: Negative Leukocyte Esterase Urine: Negative Urobilinogen: < 2 mg/dL WBC Urine: Negative RBC Urine: 0-2 /hpf Squamous Epithelial: Occ (0-10) /lpf Bacteria: Many ($g50) /hpf (A) 12/30/2020 00:26 Amphetamines: Positive (A) Barbiturates: Positive (A) Benzodiazepine: Negative Buprenorphine: Negative Cocaine: Negative Marijuana (THC): Negative Methadone: Negative Methamphetamines: Negative Opiates: Negative Oxycodone: Negative Phencyclidine: Negative Tricyclics Antidepressant TCA: Negative Propoxyphene: Negative 12/30/2020 00:36 Influenza B: Not Detected Influenza A: Not Detected SARS-CoV-2: Detected (A) 12/30/2020 00:58 CULTURE, BLOOD: Rpt pending 12/30/2020 01:04 CULTURE, BLOOD: Rpt pending ?Procedure: CT HEAD WITHOUT CONTRAST ?Date of Service: 12/29/2020 CT OF THE HEAD WITHOUT IV CONTRAST: ? INDICATION: Altered level of consciousness. ? COMPARISON: No prior exams are available for comparison. ? FINDINGS: No acute intracranial hemorrhage, mass effect, or obvious infarcts. ?Normal ventricular size. ?Rightward nasal septal deviation. ?Mildly prominent mucous retention cyst in the left maxillary sinus. ?Mild additional scattered paranasal sinus disease. ? The preliminary report was reviewed without significant discrepancy. ? IMPRESSION: No acute intracranial abnormalities. ?Scattered paranasal sinus disease, as discussed above. ? If clinical concern persists, MRI could be considered for further evaluation. ? ?Procedure: CT CHEST ABDOMEN PELVIS WITH CONTRAST ?Date of Service: 12/29/2020 CT OF THE CHEST, ABDOMEN, AND PELVIS WITH IV CONTRAST. ?ADDITIONAL MIP REFORMATTED IMAGES WERE REVIEWED. ? INDICATION: Leukocytosis, diffuse pain. ? COMPARISON: No prior exams are available for comparison. ? FINDINGS: CHEST: Shallow inspiration. ?Mild bibasilar dependent atelectasis. ?No focal consolidation, pleural effusion, or pneumothorax. ?Normal heart size. ?No definite pathologic lymphadenopathy. ?Benign-appearing bone island in T12 on the right. ?Mild degenerative change of the spine. ? ABDOMEN/PELVIS: Large probable noncalcified gallstone in the gallbladder neck measuring up to 1.9 x 3.0 cm with mildly prominent sludge throughout the remainder of the gallbladder lumen. ?No significant surrounding inflammatory change is identified at this time. ?Correlation with ultrasound is recommended for further evaluation. ? Liver, spleen, pancreas, adrenal glands, and kidneys appear grossly unremarkable. ?No hydronephrosis. ?No evidence for bowel obstruction or appendicitis. ?No definite pathologic lymphadenopathy. ?Degenerative changes of the spine. ? The preliminary report was reviewed with discrepancy as the large probable noncalcified stone and sludge in the gallbladder lumen was not mentioned on the preliminary interpretation. ? IMPRESSION: 1. ?Large probable noncalcified gallstone in the gallbladder neck with mildly prominent sludge, as discussed above. ?Correlation with ultrasound is recommended for further evaluation. 2. ?Additional nonacute/chronic findings, as detailed above. ?
CDC Split Type:

Write-up: Patient presents with ? Altered Mental Status ? Headache ? ? HPI Patient presents to ER by EMS ambulance after family called 911 as patient was incomprehensible with slurred speech and moaning on the phone this evening. On arrival of EMS patient was asleep in bed and reportedly unresponsive other that to localize to pain. EMS transferred patient to ER. On arrival to ER patient had GCS 7. Reportedly patient is locum nurse who works in a Nursing Home and patient reportedly received COVID vaccination 2 days ago and that night reportedly began complaining to family on the phone of headache, nasal congestion, sore throat, cough, fever, chills, nausea, emesis, myalgias, and lethargy. Per the medical record patient has history of seizures, migraines, and sciatica. No other information is known on patient arrival to ER. 1. Peripheral IV right dorsal hand placed by EMS in route to ER. 2. On arrival to ER GCS 7 (E1M5V1) and roving eye movements with episodic lateral conjugate and at times disconjugate gaze concerning for seizure activity. Arms and legs with moderately increased tone but no clonic movements and patient able to localize bilaterally. 3. Ativan 1 mg IVP for seizure, then further 2 mg IVP for persistent seizure. 4. Fosphenytoin 1,000 mg IVPB in ER for loading dose of antiseizure medication. 5. Patient had significant improvement following completion of Ativan 3 mg IVP and GCS improved to 14 (E3M6V5) from GCS of 7 (E1M5V1). 6. Patient able to communicate after improvement as above and reports she has had headache or migraine for past several days as well as dysuria with bilateral CVA pain and has significant pain on percussion of bilateral CVA and moderate pain on palpation of bilateral flanks. No nuchal rigidity or pain with ROM of neck. Additionally, she complains of severe headache and diffuse pain of back and abdomen/pelvis. She reports a history of seizures in the past and reports she had one last month and was treated at a hospital in her home state. She denies antiseizure medications. Additionally, patient reports nonproductive cough, sore throat, nasal congestion, fever, chills, myalgias, lethargy, nausea, and episodic emesis over the past 2 days. She has anterograde amnesia following seizure and does not recall events. 7. Normal saline 1,000 mL IV bolus, then 100 mL/hour in ER. 8. CT of head with and without contrast performed and negative for intracranial hemorrhage, lesions, stroke, or other acute pathology. 9. CT of chest/abdomen/pelvis with IV contrast shows no acute pathology or notable abnormalities. 10. Lactic acid drawn and normal. 11. UA and urine microscopy collected by straight catheterization and culture collected and pending. 12. Blood cultures x 2 collected and pending. 12. Rocephin 2 mg IVPB in ER after blood cultures collected. 13. Vancomycin 20 mg/kg (1,500 mg) IVPB following Rocephin. 14. Dexamethasone 10 mg IVP in ER. 15. Duoneb nebulizer in ER. 16. Called to discuss with patient''s daughter and the family''s preferred contact who is 23 years old. She reports patient had COVID vaccination 2 days ago and beginning that night patient has complained of headache, fever, chills, nonproductive cough, sore throat, nasal congestion, myalgias, and lethargy. Additionally, she reports patient has history of seizures on at least 1 occasion in the past a few months ago but is not on antiseizure medications. She reports patient had MRI and MRA of her brain at that time and reportedly and intracranial aneurysm was identified at that time. 17. Called to request transfer to another facility and spoke with hospitalist who states there is no neurologist there and suggests transfer to larger tertiary care facility with neurology. 18. Called to request transfer and accepted by ER provider. 19. Transfer by ALS ground ambulance with telemetry, pulse oximetry, O2 to keep $g 02%, vitals every 30 minutes, normal saline at 100 mL/hour, Rocephin 2 grams IVPB, vancomycin 20 mg/kg (1,500 mg) IVPB in ER. ? DISPOSITION Patient Stabilized and Transferred Data Unavailable Wed Dec 30, 2020 2:12 AM CST


VAERS ID: 914621 (history)  
Form: Version 2.0  
Age: 89.0  
Sex: Female  
Location: Iowa  
Vaccinated:2020-12-22
Onset:2020-12-27
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2020-12-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011J02A / 1 RA / IM

Administered by: Senior Living       Purchased by: ?
Symptoms: Death, Dementia, Fatigue
SMQs:, Dementia (narrow), Noninfectious encephalopathy/delirium (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2020-12-27
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Resident in long term care facility for 9+ years Coronary Artery Disease Dementia Hypothyroidism Hypertension
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Resident in our long term care facility who received first dose of Moderna COVID-19 Vaccine on 12/22/2020, only documented side effect was mild fatigue after receiving. She passed away on 12/27/2020 of natural causes per report. Has previously been in & out of hospice care, resided in nursing home for 9+ years, elderly with dementia. Due to proximity of vaccination we felt we should report the death, even though it is not believed to be related.


VAERS ID: 914821 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Idaho  
Vaccinated:2020-12-28
Onset:2020-12-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2020-12-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037K20A / 1 LA / IM

Administered by: Military       Purchased by: ?
Symptoms: Chest X-ray, Dizziness, Echocardiogram, Electrocardiogram, Full blood count, Hypertension, Metabolic function test, Myocardial necrosis marker, Paraesthesia oral, Peripheral swelling, Pruritus, Rash, Tachycardia
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypertension (narrow), Vestibular disorders (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (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? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: EKG, Cardiac enzymes, CBC, CMP, Chest Xray, Echo pending
CDC Split Type:

Write-up: Rash, Itching and swelling of left arm. Progressed to tachycardia in the 150''s, hypertension 200/114. Tingling of lips, dizziness


VAERS ID: 915119 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Male  
Location: Wyoming  
Vaccinated:2020-12-24
Onset:2020-12-29
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2020-12-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037K20A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: C-reactive protein increased, COVID-19 pneumonia, Chest X-ray abnormal, Computerised tomogram thorax abnormal, Dyspnoea, Fibrin D dimer increased, Hypoxia, SARS-CoV-2 test negative
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Haemorrhage laboratory terms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Respiratory failure (broad), Infective pneumonia (narrow), Opportunistic infections (broad), COVID-19 (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: albuterol, Zithromax, Advair
Current Illness: diagnosed with covid19 infection on 12/14/2020, had ulnar nerve and median nerve releases in November, 2020
Preexisting Conditions: tobacco abuse.
Allergies: no known allergies
Diagnostic Lab Data: CT of chest and CXR supported covid19 pneumonia diagnosis with marked elevation in D-dimer, CRP. interestingly SARS-CoV2 rapid antigen was negative on 12/29/2020.
CDC Split Type:

Write-up: The patient had COVID19 infection diagnosed 12/14/2020, and he stated 5 to 10 days after this, he developed shortness of breath. Had vaccine on 12/24/2020. Hypoxic and short of breath with COVID19 pneumonia on 12/29/2020. I do not know if this is an adverse effect or temporally related or if the vaccine activated prior infection.


VAERS ID: 915199 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Male  
Location: Hawaii  
Vaccinated:2020-12-30
Onset:2020-12-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2020-12-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Electrocardiogram, Ocular hyperaemia, Throat irritation
SMQs:, Anaphylactic reaction (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Glaucoma (broad)

Life Threatening? Yes
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: Lialda for colitis
Current Illness: None
Preexisting Conditions: Colitis
Allergies: None
Diagnostic Lab Data: EKG, pulse ox and blood pressure
CDC Split Type:

Write-up: Itchy throat, red eyes after 30 minutes. EMS on site gave IV Benadryl, epi pen shot and took to ER for monitoring. Vitals were good so he was discharged.


VAERS ID: 915478 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Male  
Location: Georgia  
Vaccinated:2020-12-30
Onset:2020-12-31
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2020-12-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 039K20A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Dystonic tremor, Erythema, Headache, Tachycardia, Tachypnoea
SMQs:, Anaphylactic reaction (narrow), Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dystonia (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (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? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Crestor, Allopurinol
Current Illness: N/A
Preexisting Conditions: Recovered from COVID 19. Positive on 9/11/2020
Allergies: Iodine
Diagnostic Lab Data:
CDC Split Type:

Write-up: erythema, tachycardia, tachypnea, headache, uncontrolled dystonic shaking


Result pages: prev   1 2 3 4 5 6 7 8 9 10 11 12 13   next

New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?EVENTS=ON&PAGENO=4&VAX=COVID19&VAXTYPES=COVID-19&VAXMAN=MODERNA&SERIOUS=ON

Government Disclaimer on use of this data


Copyright © 2021 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166