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From the 11/12/2021 release of VAERS data:

Found 875,292 cases where Vaccine is COVID19 and Patient Did Not Die

Government Disclaimer on use of this data



Case Details (Reverse Sorted by Onset Date)

This is page 40 out of 8,753

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VAERS ID: 1856837 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: California  
Vaccinated:2021-11-03
Onset:2021-11-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF8841 / 3 LA / OT

Administered by: Work       Purchased by: ?
Symptoms: Body temperature, Fatigue, Immunisation, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (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: LOSARTAN; AMLODIPINE BESYLATE; FLUOXETINE
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Hypertension; Sulfonamide allergy (Known allergies: sulfa drugs)
Allergies:
Diagnostic Lab Data: Test Date: 20211104; Test Name: Body temperature; Result Unstructured Data: Test Result:100 Units:[degF]; Comments: at 07:00
CDC Split Type: USPFIZER INC202101512646

Write-up: Fatigue; Fever (100F); The patient received the third/booster dose of BNT162b2; This is a spontaneous report from a contactable consumer, the patient. A 57-year-old non-pregnant female patient received the third dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: FF8841) via intramuscular route of administration in the left arm on 03Nov2021 at 11:00 (at the age of 57-years-old) as a single dose for COVID-19 immunisation. Medical history included hypertension and known allergies to sulfa drugs. Prior to the vaccination, the patient was not diagnosed with COVID-19. Concomitant medications included losartan (MANUFACTURER UNKNOWN), amlodipine besilate (MANUFACTURER UNKNOWN), fluoxetine (MANUFACTURER UNKNOWN) and multivitamin (MANUFACTURER UNKNOWN), all for an unknown indication from an unknown date and unknown if ongoing. The patient did not receive any other vaccine within four weeks prior to the COVID-19 vaccine. The patient previously received the first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: EN5318) via intramuscular route of administration in the left arm on 02Mar2021 at 14:00 (at the age of 57-years-old) and the second dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: EN6199) via intramuscular route of administration in the left arm on 25Mar2021 at 14:00 (at the age of 57-years-old) as a single dose for COVID-19 immunisation. The patient previously also received ampicillin (MANUFACTURER UNKNOWN) taken for an unknown indication on an unknown date and experienced drug allergy. On 04Nov2021 at 07:00, the patient experienced fatigue and fever (100F) the following day. The events did not result in doctor or other healthcare professional office/clinic visit, emergency room/department or urgent care. Since the vaccination, the patient had not been tested for COVID-19. No therapeutic measures were taken as a result of the events. The clinical outcome of the events fatigue and fever (100F) were resolving at the time of this report.


VAERS ID: 1856838 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-11-03
Onset:2021-11-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 32030BD / 3 RA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Immunisation, Vaccination site pain
SMQs:

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: USPFIZER INC202101512667

Write-up: Experiencing sore right arm near injection site.; The patient received the third/booster dose of BNT162b2; This is a spontaneous report from a contactable consumer, the patient. A 57-year-old male patient received third (booster) dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: 32030BD) via an unspecified route of administration in the right arm on 03Nov2021 at 18:30 (at the age of 57-years-old), as a single dose for COVID-19 immunisation. Medical history and concomitant medications were not reported. The patient did not receive any other vaccine within four weeks prior to the COVID-19 vaccine. The patient previously received first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: EL3247) via an unspecified route of administration on 03Feb2021 (at the age of 56-years-old) and second dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: EL3247) via an unspecified route of administration on 24Feb2021 (at the age of 56-years-old), as single doses for COVID-19 immunisation. On 04Nov2021, the patient woke up at 01:37 and noticed experiencing sore right arm near injection site. Soreness was minor and did not interfere with his daily tasks. The event did not result in doctor or other healthcare professional office/clinic visit, and emergency room/department or urgent care. No therapeutic measures were taken as a result of event. The clinical outcome of the event experiencing sore right arm near injection site was resolving at the time of this report. No follow-up attempts are possible. No further information is expected.


VAERS ID: 1856842 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: New York  
Vaccinated:2021-11-03
Onset:2021-11-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 330268D / 3 LA / OT

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fatigue, Immunisation, Myalgia, Pain in extremity
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (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: ALLI; MELATONIN
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Chronic autoimmune urticaria (Chronic autoimmune hives); COVID-19 (Prior to vaccination, was the patient diagnosed with COVID-19?:Yes)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101514718

Write-up: Mild to moderate fatigue; Mild muscle aches; Left arm soreness; The patient received the third/booster dose of BNT162b2; This is a spontaneous report from a contactable consumer, the patient. A 42-year-old non-pregnant female patient received third dose (booster) of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: 330268D) via an intramuscular route of administration in the left arm on 03Nov2021 at 16:00 (at the age of 42-years-old) as a single dose for COVID-19 immunisation. Medical history included chronic autoimmune hives and COVID-19. The patient had no known allergies. Prior to the vaccination, the patient was diagnosed with COVID-19. The patient did not receive any other vaccines within four weeks prior to the COVID vaccine. Concomitant medications included orlistat (ALLI), melatonin (MANUFACTURER UNKNOWN), probiotics (unspecified) and multi vitamin injection (MVI) (unspecified); all for an unknown indication from an unknown date and unknown if ongoing. The patient previously received first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: EL3247) via an intramuscular route of administration in the left arm on 08Apr2021 at 14:00 (at the age of 41-years-old) and also received second dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: EL3247) via an intramuscular route of administration in the left arm on 29Apr2021 at 12:00 (at the age of 41-years-old) as a single dose for COVID-19 immunisation. On 03Nov2021, approximately at 20:00, the patient experienced left arm soreness and was resolving as of 04Nov2021 at 17:00. On 04Nov2021, approximately at 12:00, the patient experienced mild to moderate fatigue and mild muscle aches and was ongoing as of 04Nov2021 at 17:00. The events did not result in doctor or other healthcare professional office/clinic visit, emergency room/department or urgent care. Therapeutic measures were not taken as a result of the events. Since the vaccination, the patient had not been tested for COVID-19. The clinical outcome of the events left arm soreness was resolving; while that of mild to moderate fatigue and mild muscle aches was not resolved at the time of this report.


VAERS ID: 1856945 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Male  
Location: Hawaii  
Vaccinated:2021-11-02
Onset:2021-11-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1822809 / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest pain, Hypoaesthesia, Pain, Pain in extremity, Paraesthesia, Sleep disorder
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Tendinopathies and ligament disorders (broad), Sexual dysfunction (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: None.
Current Illness: None.
Preexisting Conditions: None.
Allergies: None.
Diagnostic Lab Data:
CDC Split Type:

Write-up: Extreme pain in body. Left chest and arms. Leg pain below knee in calf area. Tingling and loss of feeling in hands. This started about 24 hours post injection and continued constantly for almost 72 hours. Since 4 days post injection pain in arms and chest occur for about 30 minutes every 3 to 4 hours. Tingling and numbness in hands and forearms is sporadic and comes and goes without any pattern. At night the pain wakes me up from Sleep 2 to 3 times a night.


VAERS ID: 1857159 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Male  
Location: California  
Vaccinated:2021-11-03
Onset:2021-11-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FH8020 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain, Chest discomfort, Chest pain, Dizziness, Fatigue, Lethargy, Nervous system disorder
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypoglycaemia (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:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Systemic: Abdominal Pain-Severe, Systemic: Chest Tightness / Heaviness / Pain-Severe, Systemic: Dizziness / Lightheadness-Severe, Systemic: Exhaustion / Lethargy-Severe, Systemic: Neurological Disorder (diagnosed by MD)-Severe


VAERS ID: 1857171 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Male  
Location: New York  
Vaccinated:2021-11-01
Onset:2021-11-03
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-11-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FH8028 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abnormal dreams, Arthralgia, Bedridden, Chills, Fatigue, Malaise, Pollakiuria
SMQs:, Arthritis (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: Chills, exhaustion, vivid dreams, joint pain in sockets of hip and shoulder frequent urination. stayed in bed for 3 days. have not sought medical attention, still not feeling 100% well at the time of this report.


VAERS ID: 1857416 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Male  
Location: California  
Vaccinated:2021-11-02
Onset:2021-11-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 071F21A / 3 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Lymphadenopathy
SMQs:, 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:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Systemic: Lymph Node Swelling-Medium, Additional Details: Patient observed swelling of right lymph node on 11/3/2021. Patient went to see primary care Doctor and the doctor informed him that it was a reaction to the moderna vaccine administered on 11/2/2021. Patient called the pharmacy on 11/9/2021 to say the inflammation has reduced and is awaiting lab results.


VAERS ID: 1857423 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-11-03
Onset:2021-11-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FE3590 / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Feeling hot, Hypoaesthesia, Loss of consciousness, Paraesthesia, Staring
SMQs:, Torsade de pointes/QT prolongation (broad), Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (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? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Approximately 7 minutes into observation, patient had a blank stare and became unconscious: sternal rub and awoke within a few seconds. Brought via wheelchair to a stretcher. Vitals taken. Patient C/O numbness and tingling in hands and feet and being hot. Ice packs to head and neck. Rested for a few minutes. Reported high anxiety around getting the vaccine and had been awake all night on call shift. Patient rested for about 20 minutes. Vitals signs taken. Was able to walk. Instructed to follow up with PCP if symptoms continued.


VAERS ID: 1857451 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-11-03
Onset:2021-11-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2593 / UNK - / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Fatigue, Headache, Injection site erythema, Injection site pain, Oropharyngeal pain
SMQs:, Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Extravasation events (injections, infusions and implants) (broad), Arthritis (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: ADDERAL
Current Illness: NONE
Preexisting Conditions: ADHD
Allergies: NONE
Diagnostic Lab Data:
CDC Split Type:

Write-up: redness and soreness around injection site for approx. 3 days. General fatigue. Severe joint soreness the first 36 hours. headache, sore throat.


VAERS ID: 1857557 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-11-03
Onset:2021-11-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 026D21A / 2 RA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Angina pectoris
SMQs:, Other ischaemic heart disease (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? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None that are known of
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Experienced sharp pain around area of heart about 3 hours after receiving vaccine. This lasted for about 2 days. I took Tylenol to try and help relieve the pain.


VAERS ID: 1857631 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-11-03
Onset:2021-11-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 040D21A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Axillary mass, Headache, Hypoacusis, Mass, Pain, Pain in extremity, Paraesthesia, Sensation of foreign body
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Hearing impairment (narrow), Tendinopathies and ligament disorders (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: RECEIVED 1ST DOSE OF MODERNA VACCINE 11/3/2021. AFTER ADMINISTRATION BEGAN WITH PAIN TO HER LEFT ARM THAT RADIATES TO HER HEAD. ALSO C/O LUMPS UNDER HER LEFT AXILLA AND NEAR HER LEFT CLAVICLE. REPORTS SHE NOW ALSO HAS A GLOBUS SENSATION THAT IS MILD TO THE LEFT SIDE OF HER THROAT WHEN SWALLOWING AND TINGLING TO THE LEFT SIDE OF HER BODY. REPORTS SOME MUFFLED HEARING TO LEFT SIDE AS WELL. DENIES RASH, SOB, CHEST PAIN, TACHYCARDIA, PALPITATIONS, OR OTHER ASSOCIATED SYMPTOMS. HAS BEEN TAKING ADVIL 600MG PO WHICH ALLEVIATES PAIN FOR 6-8 HOURS, THEN PAIN RETURNS SPOKE WITH PATIENT AT LENGTH - STRONGLY ENCOURAGED SHE PRESENT TO URGENT CARE/ER FOR FURTHER EVALUATION -AT THE VERY MINIMUM PATIENT CAN TAKE OTC BENADRYL AND IBUPROFEN 800MG Q 8 HOURS - IF ANY INCREASE IN SYMPTOMS OR IF THE DO NOT RESOLVE MUST PRESENT TO ER/URGENT CARE


VAERS ID: 1857705 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-09-28
Onset:2021-11-03
   Days after vaccination:36
Submitted: 0000-00-00
Entered: 2021-11-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 30155BA / 2 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Deep vein thrombosis, Oedema peripheral, Pain in extremity, Ultrasound scan abnormal
SMQs:, Cardiac failure (broad), Angioedema (broad), Embolic and thrombotic events, venous (narrow), Malignancy related therapeutic and diagnostic procedures (narrow), Thrombophlebitis (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Tendinopathies and ligament disorders (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: Nuvaring.
Current Illness: n/a
Preexisting Conditions: n/a
Allergies: n/a
Diagnostic Lab Data: Ultrasound.
CDC Split Type: vsafe

Write-up: I had left lower extremity pain and edema. I had these symptoms for about 5 days. I went to the hospital. I went got and ultrasound and had a DVT.


VAERS ID: 1857755 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-11-03
Onset:2021-11-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 039FU / UNK LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Condition aggravated, Feeling cold, Hyperhidrosis, Peripheral coldness, Tremor
SMQs:, Neuroleptic malignant syndrome (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Hypoglycaemia (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: Sever cold and shacking. 68 years old. 03/20/2021. COVID-19. Mederna 2nd shot.
Other Medications: metformin, pioglitazone, simvastatin, losartan, glimepiride
Current Illness: no
Preexisting Conditions: diabetes, high blood pressure
Allergies: penicillin, azithromyein, clavulanic acid
Diagnostic Lab Data: None
CDC Split Type:

Write-up: At 9:45 PM, on 11/03/2021, my hands became very cold and I began to shake uncontrollably. I got in bed and put six layers of blankets over me trying to get warm. This lasted until 12:45 AM on 11/04/2021. On that day, I had to travel out of town. At 2:45PM, I had a relapse that lasted for one and a half hours. At 1AM on 11/05/2021, I broke a sweat that trenched the bed as though I had broken a flu fever. After that, I was fine. Back in March of 2021, I had the same type reaction to my 2nd Medena vaccine, which I filed a report on.


VAERS ID: 1857806 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-11-01
Onset:2021-11-03
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-11-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1855194 / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blepharospasm, Eyelid function disorder, Facial paralysis, Vision blurred
SMQs:, Anticholinergic syndrome (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Hearing impairment (broad), Periorbital and eyelid disorders (narrow), Ocular motility disorders (narrow), 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: ASA 325mg for clotting prophylaxis
Current Illness: None
Preexisting Conditions: None
Allergies: Bactrim
Diagnostic Lab Data: The only varaible is the 2nd / ''booster'' dose of J&J liquid Patient is electing to monitor symptom at this time/ will notify PCP/clinic if condition does not spontaneously resolve.
CDC Split Type:

Write-up: Right eye began twitching / clamping shut within 2 days time. AS of 11/10/21, eyelid appeared to droop; vision is blurred in right eye at times.Right side of face is asymetrical when compared to left. No other facial discrepancies; no other notable neurological symptoms noted by mother, who is LPN


VAERS ID: 1857812 (history)  
Form: Version 2.0  
Age: 85.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-03-08
Onset:2021-11-03
   Days after vaccination:240
Submitted: 0000-00-00
Entered: 2021-11-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Fatigue, Hypoxia, Oxygen saturation decreased, SARS-CoV-2 test positive
SMQs:, Asthma/bronchospasm (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Eosinophilic pneumonia (broad), Respiratory failure (broad), Infective pneumonia (broad), 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 Sulfate HFA 108 Mcg/Ac Inhaler Amlodipine 5 Mg Tablet Carvedilol 25 Mg Tablet Donepezil 10 Mg Tablet Losartan 100 Mg Tablet Memantine 10 Mg Tablet Mirtazapine 30 Mg Tablet Sertraline 100 Mg Tablet
Current Illness:
Preexisting Conditions: Alzheimer''s Disease Dementia Depression Hyperlipidemia Hypertension Osteoporosis Pulmonary Fibrosis
Allergies: Ace Inhibitors, Hydrochlorothiazide
Diagnostic Lab Data: POSITIVE COVID TEST 11/3/21
CDC Split Type:

Write-up: HYPOXIA FATIGUE DECREASING OXYGEN SATURATION


VAERS ID: 1857968 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: California  
Vaccinated:2021-11-03
Onset:2021-11-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 033F / 3 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Chills, Diarrhoea, Dizziness, Ear pain, Eye swelling, Fatigue, Headache, Lip erythema, Lip pain, Lip swelling, Nausea, Ocular hyperaemia, Pain, Pyrexia, Swelling face
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Vestibular disorders (broad), Hypersensitivity (narrow), Arthritis (broad), Noninfectious diarrhoea (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: Tetnus (over 25 years ago)
Other Medications: hydrochlorothiazide 12.5 mg
Current Illness:
Preexisting Conditions: High blood pressure, low white blood cell count (in the range of 3.7 - 3.9) with no known cause.
Allergies: penicillin, copper
Diagnostic Lab Data:
CDC Split Type:

Write-up: 11/3 - 11/4/2021: Fever (101 & higher at times), Extreme chills, Extremely bad headache, Body Aches, Joint Aches, Nausea, Diarrhea, Exhaustion, Ears ached, Dizzy 11/5/2021: Woke up feeling much better, but realized my upper lip hurt. When I looked in the mirror, the left side of upper lip was red and swollen. By late morning (10:00am), the swelling had spread to the left lower half of my lip, and started to swell and turn red in my left under eye area. By 2:00pm, the swelling under my left eye had continued to spread towards my nose and my lips were more swollen. At 7:30pm I was finally seen by a doctor at Urgent Care who said that she did not recommend using a steroid because it would reduce the effectiveness of the vaccine, so she suggested taking Benadryl and watching to see if there were any other signs of anaphylaxis (swelling of tongue, throat, difficulty breathing, etc....). She said that if any of those symptoms appeared to go directly to an E.R.., but they did not. 11/9/2021: Swelling has mostly disappeared. 11/10/2021: Swelling and discoloration from face is completely gone.


VAERS ID: 1858007 (history)  
Form: Version 2.0  
Age: 81.0  
Sex: Unknown  
Location: Unknown  
Vaccinated:2021-04-24
Onset:2021-11-03
   Days after vaccination:193
Submitted: 0000-00-00
Entered: 2021-11-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19
SMQs:, Infective pneumonia (broad), 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Hospitalized due to covid after being vaccinated


VAERS ID: 1858030 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: New York  
Vaccinated:2021-11-03
Onset:2021-11-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 30155BA / 3 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain, Anxiety, Back pain, Diarrhoea, Exposure during pregnancy, Fatigue, Pruritus, Stress, Swelling, Urticaria
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (narrow), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Hypersensitivity (narrow), Noninfectious diarrhoea (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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Ritual prenatal vitamins
Current Illness: None
Preexisting Conditions: None
Allergies: NKA
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Adverse event: moderately itchy hives on and off on arms from wrists to armpits (NOT near injection site), neck, and belly, for approximately 72 hours (Benadryl taken PRN, approx 1x/day), then reoccurrence of hives/swelling/itchiness for 2 hours near injection site 1 week after the dose was administered (no meds taken.) Also of note, increased fatigue, mild lower back ache, mild diarrhea, slight abdominal cramping noted several hours before reoccurrence of hives observed this morning, so perhaps a stress response since I was anxious about those symptoms. Current Pregnancy: 36 weeks, 3 days. Planned c-section at 37 weeks 2 days (11/16/2021), current healthy. Previous Pregnancies: 2019 planned c-section at 37w 3d, no complications; 2017 full term stat c-section s/p complete placental abruption with neonatal death


VAERS ID: 1858100 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-10-22
Onset:2021-11-03
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 2021-11-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 012F21A / 3 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Discomfort, Oesophageal spasm, Pruritus, Sensation of foreign body, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Dystonia (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: Nuvaring Miralax Multivitamin on occasion
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None
CDC Split Type: vsafe

Write-up: I woke up around 4 in the morning on 11/3 just feeling very itchy and I realized that I had some hives. I went into the bathroom and checked myself out. I wasn''t experiencing anything else other than the itching and took a Zyrtec. And it seemed to resolve, but then it came back around 7-8pm that night and I started to get itchy again with increasing hives. There was no trouble breathing, etc. So I took Benadryl that night and took 50 mgs. And that didn''t seem to help much. So Thursday 11/4, I again woke up at 4 am and woke up really itchy and took another Zyrtec and it was widespread and moving hives. So the hives continued throughout the day and I was very itchy and it was moving around. Took Zyrtec again and even tried Pepcid for a histamine block without much relief. Friday morning 11/5 still continuing hives over most of my body besides my face. So I reached out to my PCP and she prescribed hydroxyzine and continued to do what I was already doing. I did not pick up the medication because of timing and didn''t want to take too much antihistamine. Friday evening 7-8pm, I started to feel like when I swallowed it felt like I was going to choke on something, felt like it was towards my breast. It would be uncomfortable, and it felt like a spasm of my esophagus. By Saturday morning it was still happening, so I was seen virtually Saturday morning 11/6 with Dr. and we couldn''t come up with any new triggers. So she basically recommended antihistamine twice a day, Pepcid and she suggested to take omeprazole for the esophagus feeling. She also prescribed a steroid but we talked about not taking it just yet. So Saturday and Sunday were the worst with hives, and it was all over my legs back and abdomen. It was super itchy. I did get the hydroxyzine and it didn''t feel like it was doing anything. Since yesterday, it was less dramatic. Saturday night, esophagus hasn''t been as intense, feels like a sensation but it did get better. Hives did improve yesterday, still present and visible. Still need to take Zyrtec twice a day. Calms down after a dose. Still itchy and still present. I still have not started the steroids.


VAERS ID: 1858124 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-11-03
Onset:2021-11-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (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: shingrix
Other Medications: levothyroxine, psyllium capsules, vitamin D3
Current Illness: none
Preexisting Conditions: hypothyroidism
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: soreness at injection site


VAERS ID: 1858148 (history)  
Form: Version 2.0  
Age: 80.0  
Sex: Male  
Location: New York  
Vaccinated:2021-11-02
Onset:2021-11-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939905 / 3 AR / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Insomnia, Thinking abnormal
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Psychosis and psychotic disorders (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (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: The new shingles vaccine 2019, second shot.
Other Medications: Rosuvastatin, acyclovir, Vitamin D-3, Vitamin B-12, low dosage aspirin on daily basis. Took Tylenol on Nov. 1-2 for mild back pain.
Current Illness: None
Preexisting Conditions: herpes, high cholesterol level.
Allergies: None.
Diagnostic Lab Data: none
CDC Split Type:

Write-up: When I went to bed the night after the shot (0.25ml booster) I was unable to sleep. When I would get up to urinate I would think hours had passed but it would only be about a half hour according to the clock. The next day I kept making the same time misestimates, for instance at 10:00 AM I thought it was 1 PM. I kept making misestimates of time until the early evening when I finally got up. During this period I was unable to maintain any clear or consistent thought, it was as if I had a heavy case of the flu. My thoughts kept going in a circle. I did not experience time distortion or the other symptoms after the first two shots.


VAERS ID: 1858174 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: New York  
Vaccinated:2021-10-04
Onset:2021-11-03
   Days after vaccination:30
Submitted: 0000-00-00
Entered: 2021-11-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Ear discomfort, Fatigue, Headache, Impaired work ability, Influenza A virus test negative, Influenza B virus test, Oropharyngeal pain, Respiratory syncytial virus test negative, Respiratory tract congestion, Rhinorrhoea, SARS-CoV-2 test negative, Streptococcus test negative
SMQs:, Oropharyngeal conditions (excl neoplasms, infections and allergies) (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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Fluoxetine
Current Illness: no
Preexisting Conditions: anxiety
Allergies: no
Diagnostic Lab Data: COVID test - negative; Strep test - negative; RSV - negative; Influenza A and B - negative
CDC Split Type: vsafe

Write-up: Sore throat for a couple of days for two or three days. Developed congestion, pressure in my ears; runny nose and headache. That lasted another few days. No fevers. I had fatigue. I missed one day of work. I went to Urgent Care on the 7th. They put me on Augmentin twice a day for a week. I got my flu shot probably mid September. I had it at Grocery Store. I received it on my left deltoid. I don''t know the brand name or lot number.


VAERS ID: 1858238 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-11-02
Onset:2021-11-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Chest pain, Dyspnoea, Fatigue, Headache, Malaise
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? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: HBV Vaccine (reported)
Diagnostic Lab Data:
CDC Split Type:

Write-up: Reported onset of malaise, fatigue, headache, non-exertional chest pain, non-exertional shortness of breath. Onset approx 12 hours after vaccine. Symptoms continue to persist at least 8 days after vaccine.


VAERS ID: 1858283 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Utah  
Vaccinated:2021-11-03
Onset:2021-11-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Headache, Injection site mass, 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: Metoprolol ER Succinate 25mg Trazadone 50mg
Current Illness: none
Preexisting Conditions: Heart Arrhythmia
Allergies: Adhesive Nickle Aspirin Tetracycline
Diagnostic Lab Data: none
CDC Split Type:

Write-up: I have had a headache since the evening of the injection. I also have a lump in my muscle at the injection site, and my arm itches.


VAERS ID: 1858308 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-11-02
Onset:2021-11-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037F21A / 3 - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Chest discomfort, Gait inability
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Dystonia (broad), Guillain-Barre 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: MODERNA BOOSTER - 24 HOURS AFTER HAD CHEST DISCOMFORT, WEAKNESS, AND COULD NOT WALK - WENT TO ED - DISCHARGED 8 HOURS LATER WITH NO FINDINGS AND WAS TOLD IT WAS A SIDE EFFECT OF SHOT, BACK TO NORMAL 72 HOURS LATER


VAERS ID: 1858429 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-11-03
Onset:2021-11-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1822811 / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal pain, Chills, Dyspnoea, Muscle spasms, Nausea, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Dystonia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (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: Medications: Nexplanon
Current Illness:
Preexisting Conditions: PMH: G4P3, ectopic pregnancy in 2016, C-Section x2
Allergies: Allergies: milk
Diagnostic Lab Data:
CDC Split Type:

Write-up: mins post vaccination pt experienced vomiting. Vitals: BP 70/40, HR 69, RR 22 -- $g 109/72, 68, 22 -- $g 107/77, 72 -- $g 112/77, 70 After vaccination pt became nauseous. Pt was taken to treatment area. V/S obtained and pt placed in semi-fowler. Pt experienced vomiting x2. Pt then experienced chills. PT was covered w/ blanket and given water. After nausea ceased, pt then experienced abd and back cramps that "took her breath away". Provider was wanted and advised pt to visit ER/ call emergency if symptoms persist, but if she feels ok, then she can leave. Pt expressed understanding. After 30mins pt states that she feels better and ambulated to car w/ steady gait.


VAERS ID: 1858431 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-10-25
Onset:2021-11-03
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-11-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 026D21A / 3 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Abdominal discomfort, Feeling abnormal, Headache, Nausea, SARS-CoV-2 test negative
SMQs:, Acute pancreatitis (broad), Dementia (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (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? No
Previous Vaccinations: when I was a little girl
Other Medications: Motrin cold and sinus, estroven, multivitamin
Current Illness: None
Preexisting Conditions: None
Allergies: Pennicillin
Diagnostic Lab Data: covid-19 test-negative
CDC Split Type: vsafe

Write-up: Upset stomach on got worse Thursday, Headache got very intense-worst pain. I have ever experiences, Foggy brain, Nausea, Will be doing another covid-19 test tomorrow.


VAERS ID: 1858436 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-11-02
Onset:2021-11-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939905 / 3 - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Muscle spasms, Nausea, Pain, Pain in extremity, Rash
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Dystonia (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), 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? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: In the morning i take, Vitamin D3 1000iu Sedimen 500mg, I also take Coque10 200mgs a day, I take the Sedimen in the evening again, I take Tylenol but not steady, I took Lisinopril and Lyrica 330 mg. I take Lexapro 20mgs in the morning, Ator
Current Illness: None
Preexisting Conditions: I had diabetes but its being treated for with pills and high blood pressure.
Allergies: None
Diagnostic Lab Data: Nothing has been done.
CDC Split Type: vsafe

Write-up: The first day I had sore arms, the second day I had nausea and cramps and it lasted about two day. The third to fourth day I started to get the pain and spots in my chest spreading to my back. I did go to a fast care. I had shingles once before, and it felt similar to that experience. I went to the fast care and they gave me a prescription to help with the valacyclovir hcl 1gram, its one table by mouth. 3x a day for however long the infection. There''s 21 tablets. I went to the doctor on 11/06 and started to take the medication on that day. It''s getting worse as the days go by. Its spreading from the front to the back. There is pain, its gets worse every day.


VAERS ID: 1858501 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: Rhode Island  
Vaccinated:2021-10-26
Onset:2021-11-03
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-11-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939905 / 3 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abnormal faeces, Change of bowel habit, Clostridium difficile infection, Clostridium test positive, Diarrhoea, Faecal calprotectin increased, Faeces discoloured, Giardia test negative, Headache, Impaired work ability, Laboratory test, Nausea, Nervousness, Stool analysis abnormal
SMQs:, Acute pancreatitis (broad), Pseudomembranous colitis (narrow), Biliary system related investigations, signs and symptoms (broad), Gastrointestinal nonspecific inflammation (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Ischaemic colitis (broad), Noninfectious diarrhoea (narrow), Hypoglycaemia (broad), Opportunistic infections (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: I do take a blood pressure pill every day - Losartan - 50 mg. Levothyroxine - 25 mgs. Long acting insulin med every day; 600 mg of Gabapentin; Famotidine 20 mg; Metformin 2000 mg a day; Furosemide - 40 mg a day; Alopurinol - 300 mg a day (3
Current Illness: no
Preexisting Conditions: Diabetes; Vulvar Cancer - I see a surgeon every three months to keep it under control; I have lost 50 lbs since July but I''m classified as obese.
Allergies: Sulfa; Bee stings
Diagnostic Lab Data: Stool sample - doctor sent me to get it; I had it done at Hospital - one part of it . And then I had the other part of it - the second and third container - through the another facility - life span lab. Giardia Antigen test - none detected Toxins - negative for several toxins Fecal Calprotectin - that was high - I was 402. 7 and it was suppose to be under 50. Doctor said this was high because I had the C-Diff C-Difficile toxin - PCR - it was detected - C-Difficuli free toxin - EIA - it was detected as well
CDC Split Type: vsafe

Write-up: I contacted my doctor on November 3rd and she saw me right away. On the 25th of October, I started to feel differently. My bowel movements were different. I kind of let it go because I had had a colonoscopy on 9/30/2021. I tried to call me Gastroenterologist and I didn''t hear back from her so my Primary Care doctor saw me that morning. She touched my stomach. It wasn''t bloated or sore but bowels were mustardy color, very loose and they stank a lot. I was shaky. I had a headache. I couldn''t stand without getting nausea. She sent me for stool samples. Those came back showing I had C-Diff - She prescribed 125 mg Vancomycin - I take 4 pills for 10 days. She said to stay home for a week. I won''t be going to work for a week. She has me on a bland diet to try to get bowels under control. My bowel movements are still loose but not as yellow as before. I will follow up with doctor at the end of this week. October 7th, 2021 - got my flu shot.


VAERS ID: 1858504 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-11-01
Onset:2021-11-03
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-11-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FE3590 / 3 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain, Axillary pain, Back pain, Dizziness, Fatigue, Headache, Nausea, Neck pain, Paraesthesia, Rash
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypersensitivity (narrow), Arthritis (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: Pristiq, Vyvanse, Losartan, Carvedilol, Synthroid, Triodl-l-thyronine, Aspirin, Pramipexil, Dulera, D3, B12, Airborne
Current Illness: Asthma, HBp, Depression, Chronic Lyme Disease, Sleep Disorders: Apnea & RLS, Hypo-thyroidism
Preexisting Conditions: Asthma, HBp, Depression, Chronic Lyme Disease, Sleep Disorders: Apnea & RLS, Hypo-thyroidism
Allergies: Penicillin, Sulphanomides, Codeine
Diagnostic Lab Data:
CDC Split Type:

Write-up: 10 days: extreme fatigue 5 days: severe headache; very severe nausea; dizziness, rash on arms; waves of tingling in arms, upper back, and neck; pain in L & R armpits and in abdomen.


VAERS ID: 1858977 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-11-03
Onset:2021-11-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 071F21A / 3 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chills, Erythema, Fatigue, Headache, Nausea, Pain, Peripheral swelling, Pyrexia, SARS-CoV-2 test negative
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (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? No
Previous Vaccinations:
Other Medications: Levothyroxine Metoprolol Wellbutrin Gabapentin Tramadol Excedrin Vit D3 B-Complex Biotin
Current Illness: None
Preexisting Conditions: Lupus Hashimoto?s thyroiditis Sick Sinus Syndrome Osteo and rheumatoid Arthritis
Allergies: Compazine Morphine
Diagnostic Lab Data: COVID rapid test (negative)
CDC Split Type:

Write-up: Fever (100.7) Severe body aches lasting 2-3 days Chills lasting several hours Nausea Extreme fatigue Headache Swollen and red arm lasting 4-5 days


VAERS ID: 1859026 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Female  
Location: Arkansas  
Vaccinated:2021-10-25
Onset:2021-11-03
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-11-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD0810 / 3 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Chest pain, Electrocardiogram abnormal
SMQs:, Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (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, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Alendronate, probiotic, calcium with vitamin d, Benadryl, escitalopram, multi vitamin, eye vitamin, rosuvastatin, tramadol, co q 10
Current Illness: N/A
Preexisting Conditions: Depression, fibromyalgia, high cholesterol, osteoporosis
Allergies: Lipitor - hives
Diagnostic Lab Data: EKG 11.10.2021
CDC Split Type:

Write-up: Chest pain, abnormal EKG. Vaccine was given at local Pharmacy.


VAERS ID: 1859034 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Male  
Location: Maryland  
Vaccinated:2021-09-01
Onset:2021-11-03
   Days after vaccination:63
Submitted: 0000-00-00
Entered: 2021-11-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / N/A LA / -

Administered by: Other       Purchased by: ?
Symptoms: Activated partial thromboplastin time, Angiogram, Anxiety, Blood thyroid stimulating hormone, C-reactive protein, Chest pain, Computerised tomogram, Differential white blood cell count, Echocardiogram, Electrocardiogram ST segment elevation, Full blood count, Laboratory test, Pericarditis, Prothrombin time, Tachycardia, Troponin I
SMQs:, Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Myocardial infarction (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Chronic kidney disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: NKA
Diagnostic Lab Data: CT scan, Troponin I high sensitivity, Troponin 1, Angio chest combo inc image proc, ECHO,, CBC with auto diff, CMP, PT-PTT, TSH, C reactive protein, EKG, etc
CDC Split Type:

Write-up: Chest pain, Pericarditis, Tachycardia and ST elevation. Anxiety.


VAERS ID: 1860104 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Female  
Location: Iowa  
Vaccinated:0000-00-00
Onset:2021-11-03
Submitted: 0000-00-00
Entered: 2021-11-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1855194 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Dizziness, Fatigue, Hypersomnia
SMQs:, Anticholinergic syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Depression (excl suicide and self injury) (broad), Vestibular disorders (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: Dupixent
Current Illness: Allergy multiple (patient had 30 different allergies).
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20211116579

Write-up: FELT DIZZY; COULDN''T STAY AWAKE; FATIGUE; This spontaneous report received from a patient concerned a 72 year old female. The patient''s height, and weight were not reported. The patient''s concurrent conditions included: allergies. The patient was previously treated with covid-19 vaccine ad26. cov2. s for prophylactic vaccination. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported and batch number: 1855194 expiry: 09-APR-2022) dose was not reported, administered on 03-NOV-2021 for prophylactic vaccination. Concomitant medications included dupilumab for allergies. On 03-NOV-2021, the patient experienced felt dizzy. On 03-NOV-2021, the patient experienced couldn''t stay awake. On 03-NOV-2021, the patient experienced fatigue. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from felt dizzy, couldn''t stay awake, and fatigue on 05-NOV-2021. This report was non-serious.


VAERS ID: 1860260 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Texas  
Vaccinated:2021-11-03
Onset:2021-11-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 091D21A / 3 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Expired product administered
SMQs:, Medication errors (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: We have some Moderna Covid-019 vaccine that was given after the expiration date.; This spontaneous case was reported by a health care professional and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (We have some Moderna Covid-019 vaccine that was given after the expiration date.) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 091D21A) for COVID-19 vaccination. No Medical History information was reported. On 03-Nov-2021, the patient received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 03-Nov-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (We have some Moderna Covid-019 vaccine that was given after the expiration date.). On 03-Nov-2021, EXPIRED PRODUCT ADMINISTERED (We have some Moderna Covid-019 vaccine that was given after the expiration date.) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. No concomitant medications were reported. No treatment medications were reported. It was reported that number of doses/vials were 4 vials (15 dose) 44 doses. It was reported that the date the vial initially stored in the refrigerator 24-Sep-2021. It was also reported that the date of administration of vaccine was 24-Oct-2021 to 27-Oct-2021. The vial did not undergo any temperature excursions.


VAERS ID: 1860687 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-11-03
Onset:2021-11-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 058F21A / 3 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Feeling abnormal, Headache, Loss of personal independence in daily activities, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (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: Moderna Covid #1 2/15/21 Moderna Covid#2 3/15/21
Other Medications: levothyroxine, rosuvastatin, vitamin D, diazide
Current Illness: none
Preexisting Conditions: hyperlipidemia hypertension
Allergies: hyperlipidemia
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Severe Brain fog. Severe headaches. Multi-day 99-100 F Fevers. All symptoms lasting several days. Affecting daily activities. Affecting cognitive function, driving, operating self-check-outs, cooking. Zoning out, spacing out.


VAERS ID: 1860699 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-02-02
Onset:2021-11-03
   Days after vaccination:274
Submitted: 0000-00-00
Entered: 2021-11-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3248 / 1 - / -

Administered by: Public       Purchased by: ?
Symptoms: COVID-19, Dizziness, Fall, Head injury, Loss of consciousness, SARS-CoV-2 test positive, Skin laceration, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Hostility/aggression (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad), Infective pneumonia (broad), 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Ascorbic Acid 1000 MG tablet Glucosamine-Chondroitin 500-400 MG capsule Omega-3 Fatty Acids (FISH OIL) 1000 MG CAPS Prenatal Vit-Fe Fumarate-FA (PRENATAL PLUS) 27-1 MG tablet sertraline (ZOLOFT) 100 MG tablet Vitamins A & D (VITAMIN A
Current Illness: unknown
Preexisting Conditions: Syncope and collapse Acute COVID-19 Laceration of forehead, initial encounter Fall from ground level
Allergies: clindamycin, keflex
Diagnostic Lab Data: covid test on 11/3/21
CDC Split Type:

Write-up: Patient presented to emergency department on 11/3/21 because she had lost consciousness after hitting her head on a door frame in her home. she had gotten up from bed to go to the restroom and got dizzy and fell patient was found to be covid-19 positive on 11/3/21, but did not require treatment for symptoms associated with covid. Patient was discharged to home on 11/4/21 with family.


VAERS ID: 1860737 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-11-01
Onset:2021-11-03
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-11-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 - / IM

Administered by: Public       Purchased by: ?
Symptoms: Deafness
SMQs:, Hearing impairment (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Metropolol,Norvasc,Axitinib
Current Illness: Hypertension. Renal cell carcinoma
Preexisting Conditions: Hypertension,Renal Cell Cacinoma
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Acute hearing loss


VAERS ID: 1860869 (history)  
Form: Version 2.0  
Age: 87.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-08
Onset:2021-11-03
   Days after vaccination:209
Submitted: 0000-00-00
Entered: 2021-11-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 044A21A / 1 LA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 031B21A / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, SARS-CoV-2 test positive
SMQs:, Infective pneumonia (broad), 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? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt had a positive COVID test


VAERS ID: 1860951 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Male  
Location: Wyoming  
Vaccinated:2021-11-02
Onset:2021-11-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 046C21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Dyspnoea, Pain, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (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: no
Preexisting Conditions: COPD
Allergies: Levaquin, neosporin, ceclor
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Had fever, chills, body aches and shortness of breath from 5am the next day (11/03) through 11/10.


VAERS ID: 1860992 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-11-02
Onset:2021-11-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 032F21A / 3 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Pain, Pericarditis
SMQs:, Systemic lupus erythematosus (broad), Chronic kidney disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (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: Crestor 5mg SID, daily multivitamin
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Pericarditis. Minor diffuse pain, no radiating pain, no shortness of breath or any other cardiac symptoms. SpO2, HR and BP normal. Symptoms resolved within one hour after 400mg ibuprofen p.o. Symptoms did not return after initial presentation.


VAERS ID: 1861006 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Vermont  
Vaccinated:2021-10-23
Onset:2021-11-03
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-11-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 076C21A / 3 RA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Erythema, Pruritus, Thyroid function test normal, 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? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Levothyroxine 75 MCG Sertriline 25 mg
Current Illness: n/a
Preexisting Conditions: history of asthma - however, not needed rescue inhaler in several years, seasonal allergies, Hashimotos
Allergies: Madication: allergies to anything with menthol ex: Vicks, couph drops etc. also allergic to mint, catnip, almonds, hazel nuts, tree pollen, have had hives after taking medication with red-dye unclear if that was the cause
Diagnostic Lab Data: Thyroid levels checked - came back normal
CDC Split Type:

Write-up: Booster shot on 10/23/21 - on 11/3/21 woke with red itchy scalp took Claritan which helped - on 11/4/21 woke with red, raised hives. Took Claritan again - a few hours later it had gotten worse. Seen at doctor''s office given 8 day course of prednisone - hives continued throughout the 8 days - seen by allergist. Allergist did not believe it was in response to environmental or food cause given the length of hives and believed given my auto-immune history and history of getting hives likely due to something else that my body was reacting to such as stress or possibly the booster shot - but not able to be certain. Today is 11/11/21 - I am currently taking pepcid and Zyrtec with hives still occuring but not as severe - I would still get the booster again if deemed necessary.


VAERS ID: 1861018 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-11-03
Onset:2021-11-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF8841 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Expired product administered
SMQs:, Medication errors (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: Tri-Sprintec
Current Illness: unknown
Preexisting Conditions: unknown
Allergies: none
Diagnostic Lab Data: none
CDC Split Type:

Write-up: -After review of vaccination, it was noticed that the vaccine that was administered to this patient was actually prepared on 11/1 and was therefore expired. -Medication had been refrigerated. -No known patient harm has come from this event.


VAERS ID: 1861029 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-11-03
Onset:2021-11-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF8841 / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: No adverse event, Product storage error
SMQs:, Medication errors (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: unknown
Current Illness: unknown
Preexisting Conditions: unknown
Allergies: unknown
Diagnostic Lab Data:
CDC Split Type:

Write-up: After review of vaccination, it was noticed that the vaccine that was administered this patient was actually prepared on 11/1 and was therefore expired. medication had been refrigerated. no harm has come to the patient to our knowledge based on this event.


VAERS ID: 1861041 (history)  
Form: Version 2.0  
Age: 102.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-11-03
Onset:2021-11-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF8841 / 3 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Expired product administered, No adverse event
SMQs:, Medication errors (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: unknown
Current Illness: unknown
Preexisting Conditions: unknown
Allergies: unknown
Diagnostic Lab Data:
CDC Split Type:

Write-up: After review of vaccination, it was noticed that the vaccine that was administered this patient was actually prepared on 11/1 and was therefore expired. medication had been refrigerated. no harm has come to the patient to our knowledge based on this event.


VAERS ID: 1861099 (history)  
Form: Version 2.0  
Age: 89.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-03-11
Onset:2021-11-03
   Days after vaccination:237
Submitted: 0000-00-00
Entered: 2021-11-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 040A21A / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Asthenia, COVID-19, Diarrhoea, Fatigue, SARS-CoV-2 test positive, Vaccine breakthrough infection
SMQs:, Pseudomembranous colitis (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Infective pneumonia (broad), 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, 7 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Chronic lymphocytic leukemia, hypertension
Allergies:
Diagnostic Lab Data: COVID PCR Positive on 11/9/2021
CDC Split Type:

Write-up: COVID breakthrough. Patient presented to the emergency department on 11/5/21 with 2 days of generalized weakness/fatigue and diarrhea. She was tested for COVID on 11/9/21.


VAERS ID: 1861211 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-11-03
Onset:2021-11-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 032F21A / 3 LA / IM
PPV: PNEUMO (PNEUMOVAX) / MERCK & CO. INC. U0105333 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Contusion, Dizziness, Erythema, Peripheral swelling, Sensitive skin
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemorrhage terms (excl laboratory terms) (narrow), Anticholinergic syndrome (broad), Accidents and injuries (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Vestibular disorders (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? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: hydroxychloroquine 200mg, hydrocodone/acetaminophen 5/325mg
Current Illness: nka
Preexisting Conditions: arthritis
Allergies: imidazoles, quinolones, macrolides, sulfa, cephalosporins, penicillins
Diagnostic Lab Data:
CDC Split Type:

Write-up: patient felt faint. was hypersensitive to touch. arm was swollen. redness and bruising occurred.


VAERS ID: 1861271 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-07-24
Onset:2021-11-03
   Days after vaccination:102
Submitted: 0000-00-00
Entered: 2021-11-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / SYR
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Vaccine breakthrough infection
SMQs:, Infective pneumonia (broad), 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Breakthrough COVID-19 infection. Pt received Moderna on 6/26/21 and 7/24/21


VAERS ID: 1861331 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-11-03
Onset:2021-11-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: COVID-19, Feeling abnormal, Pain, Pyrexia, SARS-CoV-2 test positive
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), 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? No
Previous Vaccinations:
Other Medications: omeprazol
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: Got the shot on Wednesday afternoon by Wednesday evening I wasn''t feeling good. I was achy all over running and fever this continued on I home tested for covid on Saturday and was positive for covid.


VAERS ID: 1861345 (history)  
Form: Version 2.0  
Age: 77.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-11-03
Onset:2021-11-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 035C21A / 3 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Incorrect dose administered
SMQs:, Medication errors (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? No
Previous Vaccinations:
Other Medications: trusopt, amitiza, xalatan
Current Illness: none
Preexisting Conditions: Bilateral glaucoma, Prediabetes, Atherosclerosis, Constipation, BPH, IBS, Hx of skin CA, Chronic Rhinitis
Allergies: Latex, statins
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Received full dose of Moderna booster instead of half dose


VAERS ID: 1861353 (history)  
Form: Version 2.0  
Age: 85.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-10-26
Onset:2021-11-03
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-11-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2593 / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blindness, Blood test, Computerised tomogram, Diplopia, Dizziness, Feeling abnormal, Headache, Magnetic resonance imaging, Migraine
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Glaucoma (broad), Optic nerve disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Ocular motility disorders (broad), Hypoglycaemia (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? No
Previous Vaccinations: Slight headache and tiredness after shot #2 - Pfizer in April 2021
Other Medications: Amlodipine, Excedrin, Multi-vitamin, Telmasartin
Current Illness: None
Preexisting Conditions: High blood pressure
Allergies: Cats
Diagnostic Lab Data: CT Scan, MRI and blood tests. Doctors also did testing for stroke multiple times.
CDC Split Type:

Write-up: A few days following the vaccination I developed the worse migraine I have ever had, plus double vision. Also I had brain fog, dizziness and I lost some vision in my right eye. On the third day I went to the ER where I was tested for stroke or brain tumor (both negative). I saw a neurologist four days later. Nine days later I continue to have double vision, a bad headache and vision loss in my right eye.


VAERS ID: 1861371 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-11-03
Onset:2021-11-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 035C21A / 3 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Incorrect dose administered
SMQs:, Medication errors (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? No
Previous Vaccinations:
Other Medications: Lipitor, Amoxicillin, Protonix, Pradaxa, Lopressor, Ecotrin, Nitroglycerin
Current Illness: None
Preexisting Conditions: Pulmonary, Sarcoidosis, A-fib, Hx of stroke, Hx of MI, CAD, Hyperlipidemia, GERD, Prediabetes, OA, Long term use of Warfarin, OA, Aphasia,
Allergies: NKDA, NKFA
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Received full dose of Moderna booster instead of half dose


VAERS ID: 1861392 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-11-03
Onset:2021-11-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 058FZIA / 3 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Lymphadenopathy
SMQs:, 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: Enalipril,Xanax,Flomax,Roboxin
Current Illness: COPD, Hypertension, anxiety
Preexisting Conditions: COPD, Hypertension, anxiety
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Swollen lymph node left collarbone


VAERS ID: 1861434 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-11-03
Onset:2021-11-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 035C21A / 3 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Incorrect dose administered
SMQs:, Medication errors (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? No
Previous Vaccinations:
Other Medications: Cellcept, Temovate, Deltasone, Fosamax, Cyclogyl
Current Illness: None
Preexisting Conditions: long term immunosuppression therapy, hand dermatitis, atopic dermatitis, hx of non-melanoma skin CA
Allergies: Bactrim, Azathioprine
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Received full dose of Moderna booster instead of half dose


VAERS ID: 1861440 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: California  
Vaccinated:2021-10-08
Onset:2021-11-03
   Days after vaccination:26
Submitted: 0000-00-00
Entered: 2021-11-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF8839 / 3 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Abortion spontaneous, Exposure during pregnancy, Haemorrhage, Ultrasound scan
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Termination of pregnancy and risk of abortion (narrow)

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: Advair daily Singulair daily
Current Illness: none
Preexisting Conditions: asthma
Allergies: penicillin
Diagnostic Lab Data: Ultrasounds- confirmed the miscarriage
CDC Split Type: vsafe

Write-up: On 11/3/2021 I started bleeding. I went to my OB twice and was informed the embryo stopped growing around 2 weeks after the booster shot. I fully miscarried 11/06/2021.


VAERS ID: 1861499 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-11-02
Onset:2021-11-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 32030BD / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test, Chest pain, Dizziness, Dyspnoea, Electrocardiogram abnormal, Headache, Inflammation, Vaccination complication
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Vestibular disorders (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? No
Previous Vaccinations:
Other Medications: Multivitamin
Current Illness: None
Preexisting Conditions: None
Allergies: Codeine
Diagnostic Lab Data: EKG (abnormal), ER visit, blood tests. Cardiologist advised inflammation following vaccine. Echocardiogram scheduled by cardiologist.
CDC Split Type:

Write-up: Chest pain, headache, dizziness, shortness of breath starting 24 hours after vaccine and chest pain continues a week later.


VAERS ID: 1861544 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: D.C.  
Vaccinated:2021-03-30
Onset:2021-11-03
   Days after vaccination:218
Submitted: 0000-00-00
Entered: 2021-11-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN8727 / UNK LA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6205 / UNK - / SYR

Administered by: Other       Purchased by: ?
Symptoms: Ophthalmological examination, Retinal exudates, Visual impairment
SMQs:, Anticholinergic syndrome (broad), Glaucoma (broad), Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (narrow), Hypoglycaemia (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: None. But I started fluoxetine on 11/1 and visual symptoms began 11/3
Current Illness: None
Preexisting Conditions: IgA Nephropathy
Allergies: Ceclor
Diagnostic Lab Data: Several eye exams on 11/11/2021
CDC Split Type:

Write-up: First vaccine shot on 3/9/2021, second on 3/30/2021. Symptoms appeared on 11/3/2021 when I noticed a substantial change in my vision in my left eye. I started on fluoxetine on 11/1, so initially believed it to be a side effect of that medication. After the issue persisted, I saw an ophthalmologist on 11/11/2021 who diagnosed me with multiple evanescent white dot syndrome. In researching, I read a report there could be a link to the Pfizer vaccine, so figured it best to report this. I am getting additional labs and have a follow-up on 11/23 to confirm the diagnosis. Typically, this disease resolves itself after a few weeks/months.


VAERS ID: 1861572 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-11-03
Onset:2021-11-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Immediate post-injection reaction, Injection site haemorrhage
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Hypersensitivity (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? No
Previous Vaccinations: Fever and sweating for 24 hrs following 2nd dose of Moderna
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Event occurred while getting my Moderna Booster for covid19. the pharmacist injected the booster into my left arm, when he removed the needle, blood spurted from my arm, onto the floor and down my arm. The pharmacist acted very surprised at the event and recalled that it had never happened to him before in many years of administering shots.


VAERS ID: 1861588 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Male  
Location: California  
Vaccinated:2021-11-01
Onset:2021-11-03
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-11-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA FH8020 / 3 LA / IM
FLU4: INFLUENZA (SEASONAL) (FLUARIX QUADRIVALENT) / GLAXOSMITHKLINE BIOLOGICALS 3NA4M / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Deep vein thrombosis, Fibrin D dimer, Pain in extremity, Peripheral swelling, Ultrasound Doppler abnormal
SMQs:, Cardiac failure (broad), Angioedema (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: D-dimer and ultrasound were preformed to evaluated whether it was a clot (Sat. morning, Nov. 6). Tests indicated that is was.
CDC Split Type:

Write-up: Pain in my right foot began on Wed. morning. Pain and swelling spread from foot to lower right leg. Intense pain Friday night. Symptoms were similar to blood clot, and a blood clot was suspected so I went to the ER Saturday (11-6). DVT was confirmed (11-6).


VAERS ID: 1861834 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Male  
Location: California  
Vaccinated:2021-11-02
Onset:2021-11-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC 3183 / 3 RA / SYR
FLU4: INFLUENZA (SEASONAL) (FLUARIX QUADRIVALENT) / GLAXOSMITHKLINE BIOLOGICALS NK45F / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Chills, Headache, Hyperhidrosis, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (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: WELLBUTRIN,BUSPAR,BYSTOLIC,CRESTOR,LOTREL,VALTREX,TAMSULOSIN
Current Illness: NONE
Preexisting Conditions: HIGH BP, ENLARGED PROSTATE,, DEPRESSION/ANXIETY
Allergies: PENICILLIN
Diagnostic Lab Data: NONE
CDC Split Type:

Write-up: FEVER 100.1-101.9, CHILLS, SWEATING, BODY ACHES, SLIGHT HEADACHE, LASTING 12-15 HOURS, BED REST. I TAKE ADVIL AND TRAMODOL FOR OTHER MEDICAL ISSUES. I DID NOT TAKE ADDITIONAL MEDICATION. FULL RECOVERY.


VAERS ID: 1861844 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-10-22
Onset:2021-11-03
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 2021-11-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 017F21A / 3 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Bronchitis, Sinusitis
SMQs:

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: Rubella booster in 1979. Anaphylactic due to egg allergy. No one asked me if I was allergic to eggs.
Other Medications: Estrovera
Current Illness: None
Preexisting Conditions: Allergies
Allergies: Sulfa, dairy, eggs and pork
Diagnostic Lab Data:
CDC Split Type:

Write-up: Sinusitis and bronchitis Augmenting and Prednisone


VAERS ID: 1862111 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Utah  
Vaccinated:2021-11-03
Onset:2021-11-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 014F21A / 3 LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Dizziness, Migraine
SMQs:, Anticholinergic syndrome (broad), Vestibular 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: Moderna Covid19 Lot030L20A date 01/29/2021 Daily Migraines for six weeks. ER visit for extreme migraine. Age 51 age 51
Other Medications: Propranolol Pantoprazole Tolterodine
Current Illness: Flu Vaccine 10/27/2021
Preexisting Conditions: Psoriatic arthritis
Allergies: Levaquin
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Dizziness Daily Migraines


VAERS ID: 1862353 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-10-23
Onset:2021-11-03
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-11-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 012F21;A / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Dizziness, Dysstasia, Hyperhidrosis, Hypertension, Induration, Nausea, Peripheral swelling
SMQs:, Cardiac failure (broad), Acute pancreatitis (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypertension (narrow), Vestibular disorders (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? No
Previous Vaccinations:
Other Medications: Statin(Lipitor), Centrum Vitamins
Current Illness: No
Preexisting Conditions: None
Allergies: No
Diagnostic Lab Data: Don''t have any, this is my personal opinion
CDC Split Type:

Write-up: The day after my second shot, my arm did blow up and was hard a a rock for almost a week. On the 10th day after the shot I started to get dizzy, didn''t think anything of it. Within the next week the dizziness got worse and finally made me nauseous , broke out in a drenching sweat and dizzy that I couldn''t stand. My blood pressure that night was 195/120. The next day my sister in law who is a nurse told me to get to the hospital after her checking my BP in both arms and my wrist. I was in the hospital with a continuous high BP. Finally received a script of Antonol and 24 hours after taking the first and second dose my BP is starting to go down. Currently it is 150/100. Back in April my BP was 117/80 according to my medical records. I have never had high blood pressure and have only been to the Drs for physicals and mammograms.


VAERS ID: 1862356 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-11-02
Onset:2021-11-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011F21A / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site bruising, Pain in extremity
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Tendinopathies and ligament disorders (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 had a very sore arm with large areas of bruising covering most of outer arm from injection site to above elbow. Patient was cautioned about the rare side effect of thrombocytopenia and advised to reach out to her md. Md does not believe this is the case as bruising was just on the one arm but ordered a CBC anyways. Patient states bruising is improving.


VAERS ID: 1862532 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-09-24
Onset:2021-11-03
   Days after vaccination:40
Submitted: 0000-00-00
Entered: 2021-11-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Heavy menstrual bleeding, Menstruation irregular, Muscle spasms
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Dystonia (broad), Fertility disorders (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: None
Current Illness: None
Preexisting Conditions: None
Allergies: No
Diagnostic Lab Data:
CDC Split Type:

Write-up: Messed up periods, after two decades of none, now I?m suddenly having 10+ days periods and horrible cramps. Short version.


VAERS ID: 1863441 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Washington  
Vaccinated:2021-11-03
Onset:2021-11-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 008C21A / UNK - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Expired product administered
SMQs:, Medication errors (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: vaccine administered past published expiry date; Based on the current case data, this case has been classified as invalid. This spontaneous case was reported by a health care professional and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (vaccine administered past published expiry date) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 008C21A) for COVID-19 vaccination. No Medical History information was reported. On 03-Nov-2021, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 03-Nov-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (vaccine administered past published expiry date). On 03-Nov-2021, EXPIRED PRODUCT ADMINISTERED (vaccine administered past published expiry date) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. No concomitant product was provided by the reporter. No treatment medication was provided.


VAERS ID: 1863445 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-11-03
Onset:2021-11-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Product dosage form confusion
SMQs:, Medication errors (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: I received my booster shot today but I was previously told that the shot should be 50mcg and she gave 25mcg; This spontaneous case was reported by a consumer and describes the occurrence of PRODUCT DOSAGE FORM CONFUSION (I received my booster shot today but I was previously told that the shot should be 50mcg and she gave 25mcg) in a male patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 03-Nov-2021, the patient received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 25 mcg. On 03-Nov-2021, the patient experienced PRODUCT DOSAGE FORM CONFUSION (I received my booster shot today but I was previously told that the shot should be 50mcg and she gave 25mcg). On 03-Nov-2021, PRODUCT DOSAGE FORM CONFUSION (I received my booster shot today but I was previously told that the shot should be 50mcg and she gave 25mcg) had resolved. Concomitant medication use was unknown Treatment information was unknown


VAERS ID: 1863448 (history)  
Form: Version 2.0  
Age: 80.0  
Sex: Unknown  
Location: Texas  
Vaccinated:2021-11-03
Onset:2021-11-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 091D21A / 3 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Expired product administered
SMQs:, Medication errors (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: We have some Moderna Covid-019 vaccine that was given after the expiration date.; This spontaneous case was reported by an other health care professional and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (We have some Moderna Covid-019 vaccine that was given after the expiration date.) in an 80-year-old patient of an unknown gender who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 091D21A) for COVID-19 vaccination. No Medical History information was reported. On 03-Nov-2021, the patient received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 03-Nov-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (We have some Moderna Covid-019 vaccine that was given after the expiration date.). On 03-Nov-2021, EXPIRED PRODUCT ADMINISTERED (We have some Moderna Covid-019 vaccine that was given after the expiration date.) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. No relevant concomitant medications were reported. Treatment information was unknown. On 24-Sep-2021, the vial was initially stored in the refrigerator. 4 vials (15 dose). 44 doses were used.


VAERS ID: 1863449 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Texas  
Vaccinated:2021-11-03
Onset:2021-11-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 091D21A / 3 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Expired product administered
SMQs:, Medication errors (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: We have some Moderna Covid-019 vaccine that was given after the expiration date.; This spontaneous case was reported by an other health care professional and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (We have some Moderna Covid-019 vaccine that was given after the expiration date.) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 091D21A) for COVID-19 vaccination. No Medical History information was reported. On 03-Nov-2021, the patient received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 03-Nov-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (We have some Moderna Covid-019 vaccine that was given after the expiration date.). On 03-Nov-2021, EXPIRED PRODUCT ADMINISTERED (We have some Moderna Covid-019 vaccine that was given after the expiration date.) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. No concomitants drugs were reported. No treatment drug was reported The vial was initially stored in the refrigerator on 24Sept2021 No temperature excursions.


VAERS ID: 1863454 (history)  
Form: Version 2.0  
Age: 78.0  
Sex: Unknown  
Location: Texas  
Vaccinated:2021-11-03
Onset:2021-11-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 091D21A / 3 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Expired product administered
SMQs:, Medication errors (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: We have some Moderna Covid-019 vaccine that was given after the expiration date.; This spontaneous case was reported by an other health care professional and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (We have some Moderna Covid-019 vaccine that was given after the expiration date.) in a 78-year-old patient of an unknown gender who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 091D21A) for COVID-19 vaccination. No Medical History information was reported. On 03-Nov-2021, the patient received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 03-Nov-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (We have some Moderna Covid-019 vaccine that was given after the expiration date.). On 03-Nov-2021, EXPIRED PRODUCT ADMINISTERED (We have some Moderna Covid-019 vaccine that was given after the expiration date.) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. The vial was initially stored in refrigerator on 24-Sep-2021.


VAERS ID: 1863456 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-11-03
Onset:2021-11-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 052E21A / 3 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Vaccination site discharge
SMQs:

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: USMODERNATX, INC.MOD20213

Write-up: some liquid (blood/vaccine?) run down their arm after the shot; This spontaneous case was reported by a pharmacist and describes the occurrence of VACCINATION SITE DISCHARGE (some liquid (blood/vaccine?) run down their arm after the shot) in a 44-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 052E21A) for COVID-19 vaccination. No Medical History information was reported. On 03-Nov-2021, the patient received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 03-Nov-2021, the patient experienced VACCINATION SITE DISCHARGE (some liquid (blood/vaccine?) run down their arm after the shot). On 03-Nov-2021, VACCINATION SITE DISCHARGE (some liquid (blood/vaccine?) run down their arm after the shot) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No Concomitant medications were provided by the reporter. No Treatment information was reported. Patient stated they have some liquid (blood/vaccine?) run down their arm after the shot, so they believe they did not get the complete dose of the booster and wants to be administered with another dose. HCP is calling to find out if there is any guidance in this respect.


VAERS ID: 1863473 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-03-03
Onset:2021-11-03
   Days after vaccination:245
Submitted: 0000-00-00
Entered: 2021-11-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 027A21A / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Accidental overdose, Pain in extremity
SMQs:, Drug abuse and dependence (broad), Tendinopathies and ligament disorders (broad), Medication errors (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: COQ-10; VITAMIN D3
Current Illness:
Preexisting Conditions: Comments: No medical history was provided by the reporter.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: experienced sore arm; full dose even though he is not immunocompromised; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (experienced sore arm) and ACCIDENTAL OVERDOSE (full dose even though he is not immunocompromised) in a 73-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 048C21A, 002B21A and 027A21A) for COVID-19 vaccination. No medical history was provided by the reporter. Concomitant products included UBIDECARENONE (COQ-10) and COLECALCIFEROL (VITAMIN D3) for an unknown indication. On 03-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 31-Mar-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 03-Nov-2021, received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 03-Nov-2021, the patient experienced ACCIDENTAL OVERDOSE (full dose even though he is not immunocompromised). On an unknown date, the patient experienced PAIN IN EXTREMITY (experienced sore arm). On 03-Nov-2021, ACCIDENTAL OVERDOSE (full dose even though he is not immunocompromised) had resolved. At the time of the report, PAIN IN EXTREMITY (experienced sore arm) outcome was unknown. No treatment information was provided. This case was linked to MOD-2021-374206, MOD-2021-374377 (Patient Link).


VAERS ID: 1863478 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Unknown  
Location: Texas  
Vaccinated:0000-00-00
Onset:2021-11-03
Submitted: 0000-00-00
Entered: 2021-11-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 091D21A / UNK - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Expired product administered
SMQs:, Medication errors (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: We have some Moderna Covid-019 vaccine that was given after the expiration date.; This spontaneous case was reported by an other health care professional and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (We have some Moderna Covid-019 vaccine that was given after the expiration date.) in a 74-year-old patient of an unknown gender who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 091D21A) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 03-Nov-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (We have some Moderna Covid-019 vaccine that was given after the expiration date.). On 03-Nov-2021, EXPIRED PRODUCT ADMINISTERED (We have some Moderna Covid-019 vaccine that was given after the expiration date.) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. It was reported that date the vial was initially stored in the refrigerator 24-Sep-2021.Date of administration of vaccine 24-Oct-2021 - 27-Oct-2021. 44 doses were stored in refrigerator. Concomitant medications was not provided by the reporter. Treatment information was not provided. This case was linked to MOD-2021-374935, MOD-2021-374694 (Patient Link).


VAERS ID: 1863487 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Michigan  
Vaccinated:2021-11-03
Onset:2021-11-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 041C21A / UNK - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Expired product administered
SMQs:, Medication errors (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: Patient that received a dose of Moderna vaccine that expired 11/1; Based on the current case data, this case has been classified as invalid. This spontaneous case was reported by a nurse and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (Patient that received a dose of Moderna vaccine that expired 11/1) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 041C21A) for COVID-19 vaccination. No Medical History information was reported. On 03-Nov-2021, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 03-Nov-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (Patient that received a dose of Moderna vaccine that expired 11/1). On 03-Nov-2021, EXPIRED PRODUCT ADMINISTERED (Patient that received a dose of Moderna vaccine that expired 11/1) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. Patient had no adverse event. On 16-Oct-2021 vial was initially stored in the refrigerator. No concomitant medications were reported. No treatment information was provided. Most recent FOLLOW-UP information incorporated above includes: On 04-Nov-2021: Additional information includes updated reporter contact information,Added date of administration of vaccine. On 04-Nov-2021: Additional information includes Added batch/lot number,narrative was updated.


VAERS ID: 1863489 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Unknown  
Location: Texas  
Vaccinated:0000-00-00
Onset:2021-11-03
Submitted: 0000-00-00
Entered: 2021-11-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 091D21A / 3 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Expired product administered
SMQs:, Medication errors (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: We have some Moderna Covid-019 vaccine that was given after the expiration date.; This spontaneous case was reported by an other health care professional and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (We have some Moderna Covid-019 vaccine that was given after the expiration date.) in a 64-year-old patient of an unknown gender who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 091D21A) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 03-Nov-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (We have some Moderna Covid-019 vaccine that was given after the expiration date.). On 03-Nov-2021, EXPIRED PRODUCT ADMINISTERED (We have some Moderna Covid-019 vaccine that was given after the expiration date.) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. Date the vial was initially stored in the refrigerator 24- Sept-2021. Date of administration of vaccine 24Oct2021 - 27Oct2021 No concomitant medications was reported. no treatment was reported.


VAERS ID: 1863511 (history)  
Form: Version 2.0  
Age: 78.0  
Sex: Unknown  
Location: Texas  
Vaccinated:0000-00-00
Onset:2021-11-03
Submitted: 0000-00-00
Entered: 2021-11-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 091D21A / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Expired product administered
SMQs:, Medication errors (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: We have some Moderna Covid-019 vaccine that was given after the expiration date.; This spontaneous case was reported by an other health care professional and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (We have some Moderna Covid-019 vaccine that was given after the expiration date.) in a 78-year-old patient of an unknown gender who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 091D21A) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form and first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 03-Nov-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (We have some Moderna Covid-019 vaccine that was given after the expiration date.). At the time of the report, EXPIRED PRODUCT ADMINISTERED (We have some Moderna Covid-019 vaccine that was given after the expiration date.) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. no concomitant and treatment drugs were provided. Date the vial was initially stored in the refrigerator: 24Sept2021 o*Date(s) of administration of vaccine: 24Oct2021 - 27Oct2021 This case was linked to MOD-2021-374935 (Patient Link).


VAERS ID: 1863517 (history)  
Form: Version 2.0  
Age: 78.0  
Sex: Unknown  
Location: Texas  
Vaccinated:0000-00-00
Onset:2021-11-03
Submitted: 0000-00-00
Entered: 2021-11-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 091D21A / UNK - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Expired product administered
SMQs:, Medication errors (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: We have some Moderna Covid-019 vaccine that was given after the expiration date.; This spontaneous case was reported by a nurse and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (We have some Moderna Covid-019 vaccine that was given after the expiration date.) in a 78-year-old patient of an unknown gender who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 091D21A) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 03-Nov-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (We have some Moderna Covid-019 vaccine that was given after the expiration date.). On 03-Nov-2021, EXPIRED PRODUCT ADMINISTERED (We have some Moderna Covid-019 vaccine that was given after the expiration date.) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. No Concomitant medications were reported. No Treatment information was reported.


VAERS ID: 1863526 (history)  
Form: Version 2.0  
Age: 89.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-01-14
Onset:2021-11-03
   Days after vaccination:293
Submitted: 0000-00-00
Entered: 2021-11-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 039K20A / 1 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Dysstasia, Injection site joint pain, Insomnia, Pain in extremity, Vaccination site mass
SMQs:, Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: Right leg pain from foot to hip; He couldn''t sleep because of the pain.; He states there''s a bump there, but it has gone down some today.; He couldn''t stand; He still has pain in the shoulder; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY, INSOMNIA, VACCINATION SITE MASS, DYSSTASIA, and INJECTION SITE JOINT PAIN in an 89-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 032F21A, 027L20A and 039K20A) for COVID-19 vaccination. No Medical History information was reported. On 14-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 11-Feb-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 03-Nov-2021, received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 03-Nov-2021, the patient experienced PAIN IN EXTREMITY, INSOMNIA, DYSTASIA, and INJECTION SITE JOINT PAIN. 03-Nov-2021, the patient experienced VACCINATION SITE MASS. On 03-Nov-2021, PAIN IN EXTREMITY, INSOMNIA, and VACCINATION SITE MASS had resolved. At the time of the report, DYSTASIA was resolving and INJECTION SITE JOINT PAIN had not resolved. No concomitant information was reported. No treatment information was reported. Patient date of birth was mentioned like this in source document 20210320 (20-MAR-2021).


VAERS ID: 1863528 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-02-20
Onset:2021-11-03
   Days after vaccination:256
Submitted: 0000-00-00
Entered: 2021-11-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Chest pain, Vaccination site pain
SMQs:, 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: CYCLOBENZAPRINE; LEVOTHYROXINE; BUSPAR; MYRBETRIQ
Current Illness: Anxiety
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: 30 minutes after 3rd dose felt chest constriction lasting 4 hours, "Like an elephant on chest when you have COVID; soreness at injection site; This spontaneous case was reported by a consumer and describes the occurrence of CHEST PAIN (30 minutes after 3rd dose felt chest constriction lasting 4 hours, "Like an elephant on chest when you have COVID) and VACCINATION SITE PAIN (soreness at injection site) in a 48-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 071F21A) for COVID-19 vaccination. Concurrent medical conditions included Anxiety. Concomitant products included BUSPIRONE HYDROCHLORIDE (BUSPAR) for Anxiety, CYCLOBENZAPRINE for Muscle relaxant, LEVOTHYROXINE and MIRABEGRON (MYRBETRIQ) for an unknown indication. On 20-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 20-Mar-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 03-Nov-2021, received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to .5 ml. On 03-Nov-2021, the patient experienced CHEST PAIN (30 minutes after 3rd dose felt chest constriction lasting 4 hours, "Like an elephant on chest when you have COVID) and VACCINATION SITE PAIN (soreness at injection site). The patient was treated with PARACETAMOL (TYLENOL [PARACETAMOL]) for Adverse event, at a dose of 1 dosage form and IBUPROFEN for Adverse event, at a dose of 1 dosage form. On 03-Nov-2021, CHEST PAIN (30 minutes after 3rd dose felt chest constriction lasting 4 hours, "Like an elephant on chest when you have COVID) had resolved. At the time of the report, VACCINATION SITE PAIN (soreness at injection site) outcome was unknown. This case was linked to MOD-2021-374850 (Patient Link).


VAERS ID: 1863534 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Unknown  
Location: Texas  
Vaccinated:0000-00-00
Onset:2021-11-03
Submitted: 0000-00-00
Entered: 2021-11-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 091D21A / 3 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Expired product administered
SMQs:, Medication errors (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: We have some Moderna Covid-019 vaccine that was given after the expiration date.; This spontaneous case was reported by a nurse and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (We have some Moderna Covid-019 vaccine that was given after the expiration date.) in a 74-year-old patient of an unknown gender who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 091D21A) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 03-Nov-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (We have some Moderna Covid-019 vaccine that was given after the expiration date.). On 03-Nov-2021, EXPIRED PRODUCT ADMINISTERED (We have some Moderna Covid-019 vaccine that was given after the expiration date.) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No relevant concomitant medication was reported. Treatment information were not provided.


VAERS ID: 1863539 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Ohio  
Vaccinated:2021-11-03
Onset:2021-11-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 041C21A / 3 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Expired product administered
SMQs:, Medication errors (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: Expired doses were administered to 12 patients; Based on the current case data, this case has been classified as invalid. This spontaneous case was reported by a nurse and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (Expired doses were administered to 12 patients) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 041C21A) for COVID-19 vaccination. No Medical History information was reported. On 03-Nov-2021, the patient received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 03-Nov-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (Expired doses were administered to 12 patients). On 03-Nov-2021, EXPIRED PRODUCT ADMINISTERED (Expired doses were administered to 12 patients) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. Concomitant medication details were not provided. Treatment details were not provided.


VAERS ID: 1863551 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Unknown  
Location: Texas  
Vaccinated:2021-11-03
Onset:2021-11-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 091D21A / 3 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Expired product administered
SMQs:, Medication errors (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: Moderna Covid-019 vaccine was given after the expiration date.; This spontaneous case was reported by a health care professional and describes the occurrence of EXPIRED PRODUCT ADMINISTERED ( Moderna Covid-019 vaccine was given after the expiration date.) in a 69-year-old patient of an unknown gender who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 091D21A) for COVID-19 vaccination. No Medical History information was reported. On 03-Nov-2021, the patient received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 03-Nov-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED ( Moderna Covid-019 vaccine was given after the expiration date.). On 03-Nov-2021, EXPIRED PRODUCT ADMINISTERED ( Moderna Covid-019 vaccine was given after the expiration date.) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. Number of doses/vials: 4 vials (15 dose). 44 doses Date the vial was initially stored in the refrigerator: 24Sept2021 Date(s) of administration of vaccine: 24Oct2021 - 27Oct2021 Consent given for Safety follow up/contact with caller. No concomitant medications were administered. No treatment medications were reported.


VAERS ID: 1863570 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Connecticut  
Vaccinated:2021-01-07
Onset:2021-11-03
   Days after vaccination:300
Submitted: 0000-00-00
Entered: 2021-11-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Mass, Pain in extremity, Rash, Skin discolouration
SMQs:, Anaphylactic reaction (broad), Hypotonic-hyporesponsive episode (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: Arm hurts; Pinkish and in one area the look like dots and the other are they are is bigger; Raised bumps; Rash on my stomach also on my lower back/rib section; This spontaneous case was reported by an other health care professional and describes the occurrence of PAIN IN EXTREMITY (Arm hurts), SKIN DISCOLOURATION (Pinkish and in one area the look like dots and the other are they are is bigger), MASS (Raised bumps) and RASH (Rash on my stomach also on my lower back/rib section) in a 54-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 058E21A) for COVID-19 vaccination. No Medical History information was reported. On 07-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 04-Feb-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 02-Nov-2021, received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 03-Nov-2021, the patient experienced PAIN IN EXTREMITY (Arm hurts), SKIN DISCOLOURATION (Pinkish and in one area the look like dots and the other are they are is bigger), MASS (Raised bumps) and RASH (Rash on my stomach also on my lower back/rib section). At the time of the report, PAIN IN EXTREMITY (Arm hurts), SKIN DISCOLOURATION (Pinkish and in one area the look like dots and the other are they are is bigger), MASS (Raised bumps) and RASH (Rash on my stomach also on my lower back/rib section) had not resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. No Concomitant medications were reported. No Treatment details were reported.


VAERS ID: 1863573 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Unknown  
Location: Texas  
Vaccinated:2021-11-03
Onset:2021-11-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 091D21A / 3 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Expired product administered
SMQs:, Medication errors (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: We have some Moderna Covid-019 vaccine that was given after the expiration date.; This spontaneous case was reported by an other health care professional and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (We have some Moderna Covid-019 vaccine that was given after the expiration date.) in a 26-year-old patient of an unknown gender who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 091D21A) for COVID-19 vaccination. No Medical History information was reported. On 03-Nov-2021, the patient received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 03-Nov-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (We have some Moderna Covid-019 vaccine that was given after the expiration date.). On 03-Nov-2021, EXPIRED PRODUCT ADMINISTERED (We have some Moderna Covid-019 vaccine that was given after the expiration date.) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. No concomitant medication provided No treatment medication provided


VAERS ID: 1863578 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Unknown  
Location: Texas  
Vaccinated:0000-00-00
Onset:2021-11-03
Submitted: 0000-00-00
Entered: 2021-11-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 091D21A / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Expired product administered
SMQs:, Medication errors (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: We have some Moderna Covid-019 vaccine that was given after the expiration date.; This spontaneous case was reported by a health care professional and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (We have some Moderna Covid-019 vaccine that was given after the expiration date.) in a 71-year-old patient of an unknown gender who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 091D21A) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 03-Nov-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (We have some Moderna Covid-019 vaccine that was given after the expiration date.). At the time of the report, EXPIRED PRODUCT ADMINISTERED (We have some Moderna Covid-019 vaccine that was given after the expiration date.) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. No concomitants are provided No treatments are provided


VAERS ID: 1863587 (history)  
Form: Version 2.0  
Age: 80.0  
Sex: Female  
Location: New Hampshire  
Vaccinated:2021-02-08
Onset:2021-11-03
   Days after vaccination:268
Submitted: 0000-00-00
Entered: 2021-11-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 028L20A / 1 RA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Urinary tract infection
SMQs:

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: USMODERNATX, INC.MOD20213

Write-up: She was diagnosed with a "UTI" this morning; This spontaneous case was reported by a consumer and describes the occurrence of URINARY TRACT INFECTION (She was diagnosed with a "UTI" this morning) in an 81-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 028L20A) for COVID-19 vaccination. No Medical History information was reported. On 08-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 08-Mar-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 03-Nov-2021, after starting mRNA-1273 (Moderna COVID-19 Vaccine), the patient experienced URINARY TRACT INFECTION (She was diagnosed with a "UTI" this morning). At the time of the report, URINARY TRACT INFECTION (She was diagnosed with a "UTI" this morning) had not resolved. No concomitant medication information was provided. Treatment medication include antibiotics for UTI. The patient took booster dose on 04Nov2021and had no side effects. Most recent FOLLOW-UP information incorporated above includes: On 04-Nov-2021: Follow-up includes booster dose information was added.


VAERS ID: 1863609 (history)  
Form: Version 2.0  
Age: 82.0  
Sex: Unknown  
Location: Texas  
Vaccinated:0000-00-00
Onset:2021-11-03
Submitted: 0000-00-00
Entered: 2021-11-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 091D21A / 3 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Expired product administered
SMQs:, Medication errors (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: We have some Moderna Covid-019 vaccine that was given after the expiration date.; This spontaneous case was reported by an other health care professional and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (We have some Moderna Covid-019 vaccine that was given after the expiration date.) in an 82-year-old patient of an unknown gender who received mRNA-1273 (COVID 19 Vaccine Moderna) (batch no. 091D21A) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received third dose of mRNA-1273 (COVID 19 Vaccine Moderna) (unknown route) 1 dosage form. On 03-Nov-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (We have some Moderna Covid-019 vaccine that was given after the expiration date.). On 03-Nov-2021, EXPIRED PRODUCT ADMINISTERED (We have some Moderna Covid-019 vaccine that was given after the expiration date.) had resolved. For mRNA-1273 (COVID 19 Vaccine Moderna) (Unknown), the reporter did not provide any causality assessments. No concomitant medication reported. No treatment medication reported. Date of the vials was initially stored in the refrigerator: 24Sept2021


VAERS ID: 1863610 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Unknown  
Location: Texas  
Vaccinated:2021-11-03
Onset:2021-11-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 091D21A / 3 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Expired product administered
SMQs:, Medication errors (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: We have some Moderna Covid-019 vaccine that was given after the expiration date.; This spontaneous case was reported by another health care professional and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (We have some Moderna Covid-019 vaccine that was given after the expiration date.) in a 62-year-old patient of an unknown gender who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 091D21A) for COVID-19 vaccination. No Medical History information was reported. On 03-Nov-2021, the patient received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) .25 ml. On 03-Nov-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (We have some Moderna Covid-019 vaccine that was given after the expiration date.). On 03-Nov-2021, EXPIRED PRODUCT ADMINISTERED (We have some Moderna Covid-019 vaccine that was given after the expiration date.) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. Concomitant medications were not provided Treatment medications were not provided It was reported that 4 vials (15 dose). 44 doses. vials were stored in the refrigerator on 24-sep-2021. Vaccine was administration between 24Oct2021 - 27Oct2021. vials did not undergo any temperature excursions.


VAERS ID: 1863627 (history)  
Form: Version 2.0  
Age: 86.0  
Sex: Female  
Location: California  
Vaccinated:2021-01-27
Onset:2021-11-03
   Days after vaccination:280
Submitted: 0000-00-00
Entered: 2021-11-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Pain in extremity
SMQs:, 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: Sore arm; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (Sore arm) in an 86-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 27-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 24-Feb-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 03-Nov-2021, received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 03-Nov-2021, after starting mRNA-1273 (Moderna COVID-19 Vaccine), the patient experienced PAIN IN EXTREMITY (Sore arm). At the time of the report, PAIN IN EXTREMITY (Sore arm) outcome was unknown. No concomitant medications were provided by the reporter. No treatment medications were provided by the reporter.


VAERS ID: 1863645 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-01-08
Onset:2021-11-03
   Days after vaccination:299
Submitted: 0000-00-00
Entered: 2021-11-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 RA / OT

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fatigue, Hot flush, Nausea
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (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:
Current Illness: Allergy to antibiotic (maculopapular rash); Migraine; Nausea
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: Fatigue; Hot flashes; intense nausea; This spontaneous case was reported by a pharmacist and describes the occurrence of HOT FLUSH (Hot flashes), NAUSEA (intense nausea) and FATIGUE (Fatigue) in a 39-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 939904) for COVID-19 vaccination. Concurrent medical conditions included Migraine since 2008, Nausea and Allergy to antibiotic (maculopapular rash). On 08-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 05-Feb-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 03-Nov-2021, received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to .25 milliliter. On 03-Nov-2021, the patient experienced HOT FLUSH (Hot flashes) and NAUSEA (intense nausea). On 04-Nov-2021, the patient experienced FATIGUE (Fatigue). The patient was treated with ONDANSETRON (oral) ongoing since an unknown date for Migraine, at a dose of 8 milligram as necessary. On 03-Nov-2021, HOT FLUSH (Hot flashes) and NAUSEA (intense nausea) had resolved. On 04-Nov-2021, FATIGUE (Fatigue) had resolved. Not Provided For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter considered HOT FLUSH (Hot flashes), NAUSEA (intense nausea) and FATIGUE (Fatigue) to be related. Three hours after the vaccine administration had intense nausea and hot flashes not associated with migraine. The patient took 8 mg ODT of Ondansetron and symptoms resolved after 45 minutes. No other adverse experience were reported. Most recent FOLLOW-UP information incorporated above includes: On 07-Nov-2021: Follow up received on 07-Nov-2021. Updated patient demographics, medical history, dose 1 and dose 2 details, and event fatigue updated.


VAERS ID: 1863648 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Male  
Location: California  
Vaccinated:0000-00-00
Onset:2021-11-03
Submitted: 0000-00-00
Entered: 2021-11-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Malaise, SARS-CoV-2 test
SMQs:, Infective pneumonia (broad), 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? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20211103; Test Name: COVID-19 virus test.; Test Result: Positive ; Result Unstructured Data: Positive
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: Feeling Sick; COVID-19 diagnosis/received the positive result of the test; This spontaneous case was reported by a consumer and describes the occurrence of COVID-19 (COVID-19 diagnosis/received the positive result of the test) and MALAISE (Feeling Sick) in a 29-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 03-Nov-2021, the patient experienced COVID-19 (COVID-19 diagnosis/received the positive result of the test). On an unknown date, the patient experienced MALAISE (Feeling Sick). At the time of the report, COVID-19 (COVID-19 diagnosis/received the positive result of the test) and MALAISE (Feeling Sick) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 03-Nov-2021, SARS-CoV-2 test: positive (Positive) Positive. The patient went to get moderna booster dose and also received the positive result of the COVID 19 test. No concomitant medications were reported. No treatment information was provided This case concerns a 29 year-old male patient with no reported medical history who experienced the unexpected adverse event of special interest of COVID-19. The event occurred approximately on an unknown date relative to vaccination with the third dose of Moderna COVID-19 Vaccine. The benefit-risk relationship of Moderna COVID-19 Vaccine is not affected by this report.; Sender''s Comments: This case concerns a 29 year-old male patient with no reported medical history who experienced the unexpected adverse event of special interest of COVID-19. The event occurred approximately on an unknown date relative to vaccination with the third dose of Moderna COVID-19 Vaccine. The benefit-risk relationship of Moderna COVID-19 Vaccine is not affected by this report.


VAERS ID: 1863649 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-11-03
Onset:2021-11-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Pain in extremity
SMQs:, 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: This spontaneous case reported by a consumer, describes the occurrence of pain in extremity (sore arm eight hours after the booster and is still on going) in a 74-year-old female patient who received mRNA-1273 (Moderna COVID-19 vaccine) for COVID-19 immunization. No medical history reported. On Feb 20, 2021, patient received the first dose of mRNA-1273 (Moderna COVID-19 vaccine), intramuscular; 1 dosage form. April 2021, patient received the second dose of mRNA-1273 (Moderna COVID-19 vaccine), unknown route; 1 dosage form. On Nov 3, 2021, patient received the third dose of mRNA-1273 (Moderna COVID-19 vaccine), unknown route; 1 dosage form. On Nov 3, 2021, after the mRNA-1273 (Moderna COVID-19 vaccine), patient had pain in extremity (sore arm eight hours after the booster and is still on going). At the time of the report, pain in extremity (sore arm eight hours after the booster and is still on going): not resolved. No concomitant medication or treatment information provided. This case linked to MOD-2021-375348 (patient link).


VAERS ID: 1863677 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Female  
Location: Idaho  
Vaccinated:2021-03-31
Onset:2021-11-03
   Days after vaccination:217
Submitted: 0000-00-00
Entered: 2021-11-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 RA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Arthralgia, Chills, Fatigue, Headache, Inappropriate schedule of product administration, Nausea, Vaccination site erythema, Vaccination site swelling
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Arthritis (broad), Medication errors (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? No
Previous Vaccinations:
Other Medications:
Current Illness: Blood pressure high
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: Less than 6 months for administration of booster dose after 2nd dose; Swelling in right arm; Redness in right arm; Fatigue; Headache; Joint pain; Chills; Nauseousness; This spontaneous case was reported by a consumer and describes the occurrence of INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (Less than 6 months for administration of booster dose after 2nd dose), VACCINATION SITE SWELLING (Swelling in right arm), VACCINATION SITE ERYTHEMA (Redness in right arm), FATIGUE (Fatigue) and HEADACHE (Headache) in a 71-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. Concurrent medical conditions included Blood pressure high. On 31-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. In July 2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 03-Nov-2021, received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 03-Nov-2021, the patient experienced INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (Less than 6 months for administration of booster dose after 2nd dose), VACCINATION SITE SWELLING (Swelling in right arm), VACCINATION SITE ERYTHEMA (Redness in right arm), FATIGUE (Fatigue), HEADACHE (Headache), ARTHRALGIA (Joint pain), CHILLS (Chills) and NAUSEA (Nauseousness). On 03-Nov-2021, INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (Less than 6 months for administration of booster dose after 2nd dose) had resolved. At the time of the report, VACCINATION SITE SWELLING (Swelling in right arm), VACCINATION SITE ERYTHEMA (Redness in right arm), FATIGUE (Fatigue), HEADACHE (Headache), ARTHRALGIA (Joint pain), CHILLS (Chills) and NAUSEA (Nauseousness) had not resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. Concomitant medications include High blood pressure medication. No Treatment information was reported. This case was linked to MOD-2021-375447 (Patient Link).


VAERS ID: 1863678 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-11-01
Onset:2021-11-03
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-11-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal pain, Chills, Diarrhoea, Fatigue, Headache
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (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? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: Abdominal cramping; Diarrhea; Headache; Chills; Fatigue; This spontaneous case was reported by a consumer and describes the occurrence of ABDOMINAL PAIN (Abdominal cramping), DIARRHEA (Diarrhea), HEADACHE (Headache), CHILLS (Chills) and FATIGUE (Fatigue) in a 50-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 01-Nov-2021, the patient received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 03-Nov-2021, the patient experienced ABDOMINAL PAIN (Abdominal cramping), DIARRHEA (Diarrhea), HEADACHE (Headache), CHILLS (Chills) and FATIGUE (Fatigue). At the time of the report, ABDOMINAL PAIN (Abdominal cramping), DIARRHEA (Diarrhea), HEADACHE (Headache), CHILLS (Chills) and FATIGUE (Fatigue) outcome was unknown. Patient had received J&J vaccine for the first dose. No concomitant product was provided by the reporter. No treatment medication was provided.


VAERS ID: 1863696 (history)  
Form: Version 2.0  
Age: 77.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-11-03
Onset:2021-11-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 032F21A / 3 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Body temperature, Pyrexia, Vaccination complication
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (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: Test Date: 20211104; Test Name: Body temperature; Result Unstructured Data: fever of 100F.
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: fever of 100F; usual side effects; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION COMPLICATION (usual side effects) and PYREXIA (fever of 100F) in a 77-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 032F21A) for COVID-19 vaccination. Previously administered products included for Product used for unknown indication: Pfizer (EL3247, First dose) on 15-Jan-2021, Pfizer (EL9264 and Second dose) on 07-Feb-2021. Past adverse reactions to the above products included No adverse event with Pfizer and Pfizer. On 03-Nov-2021, the patient received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 03-Nov-2021, the patient experienced VACCINATION COMPLICATION (usual side effects). On 04-Nov-2021, the patient experienced PYREXIA (fever of 100F). At the time of the report, VACCINATION COMPLICATION (usual side effects) and PYREXIA (fever of 100F) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 04-Nov-2021, Body temperature: 100f (High) fever of 100F.. No concomitant medication was provided. No treatment information was provided


VAERS ID: 1863708 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-03-10
Onset:2021-11-03
   Days after vaccination:238
Submitted: 0000-00-00
Entered: 2021-11-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011A21A / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Diarrhoea, Vaccination site pain, Vomiting
SMQs:, Acute pancreatitis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (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? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: right arm is very sore; diarrhea; throwing up; This spontaneous case was reported by a consumer and describes the occurrence of DIARRHOEA (diarrhea), VOMITING (throwing up) and VACCINATION SITE PAIN (right arm is very sore) in a 64-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 077C21B, 027B21A and 011A21A) for COVID-19 vaccination. No Medical History information was reported. On 10-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 13-Apr-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 03-Nov-2021, received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 03-Nov-2021, the patient experienced DIARRHOEA (diarrhea) and VOMITING (throwing up). On 04-Nov-2021, the patient experienced VACCINATION SITE PAIN (right arm is very sore). At the time of the report, DIARRHOEA (diarrhea), VOMITING (throwing up) and VACCINATION SITE PAIN (right arm is very sore) outcome was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. No concomitant medications were reported No treatment medications were reported


VAERS ID: 1863718 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Oklahoma  
Vaccinated:2021-11-03
Onset:2021-11-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 0409D8A / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Chest pain, Diarrhoea, Dyspnoea, Fatigue, Headache, Illness
SMQs:, Anaphylactic reaction (broad), Pseudomembranous colitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Noninfectious diarrhoea (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? No
Previous Vaccinations:
Other Medications: LISINOPRIL
Current Illness: Blood pressure abnormal
Preexisting Conditions: Medical History/Concurrent Conditions: COVID-19
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: Chest pain; Difficulty breathing; Diarrhea; Headache; very tired and lost not knowing what to do; feeling very sick; This spontaneous case was reported by a consumer and describes the occurrence of CHEST PAIN (Chest pain), DYSPNOEA (Difficulty breathing), DIARRHOEA (Diarrhea), ILLNESS (feeling very sick) and HEADACHE (Headache) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 0409D8A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. The patient''s past medical history included COVID-19. Concurrent medical conditions included Blood pressure abnormal. Concomitant products included LISINOPRIL for Blood pressure abnormal. On 03-Nov-2021 at 2:00 AM, the patient received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On an unknown date, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. In 2021, the patient experienced ILLNESS (feeling very sick). 2021, the patient experienced FATIGUE (very tired and lost not knowing what to do). On 03-Nov-2021 at 7:00 AM, the patient experienced CHEST PAIN (Chest pain), DYSPNOEA (Difficulty breathing), DIARRHOEA (Diarrhea) and HEADACHE (Headache). At the time of the report, CHEST PAIN (Chest pain), DYSPNOEA (Difficulty breathing), DIARRHOEA (Diarrhea), ILLNESS (feeling very sick), HEADACHE (Headache) and FATIGUE (very tired and lost not knowing what to do) had not resolved. No treatment medication has been provided.


VAERS ID: 1863761 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-11-02
Onset:2021-11-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025D21A / 3 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Fatigue, Feeling cold, Influenza, Vaccination complication
SMQs:, Infective pneumonia (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: LISINOPRIL; HYDRALAZINE; PROZAC; LORAZEPAM
Current Illness:
Preexisting Conditions: Comments: No medical history was provided by the reporter.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: flu symptoms; she felt sick; patient had cold in the body; fatigue; This case was received via an unknown source (no reference has been entered for a health authority or license partner) on 06-Nov-2021 and was forwarded to Moderna on 07-Nov-2021. This spontaneous case was reported by a consumer and describes the occurrence of INFLUENZA (flu symptoms), VACCINATION COMPLICATION (she felt sick), FEELING COLD (patient had cold in the body) and FATIGUE (fatigue) in a 79-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 025D21A) for COVID-19 vaccination. No medical history was provided by the reporter. Concomitant products included LISINOPRIL, HYDRALAZINE, FLUOXETINE HYDROCHLORIDE (PROZAC) and LORAZEPAM for an unknown indication. On 02-Nov-2021, the patient received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 03-Nov-2021, the patient experienced INFLUENZA (flu symptoms), VACCINATION COMPLICATION (she felt sick), FEELING COLD (patient had cold in the body) and FATIGUE (fatigue). The patient was treated with PARACETAMOL (TYLENOL [PARACETAMOL]) for Adverse event, at an unspecified dose and frequency. At the time of the report, INFLUENZA (flu symptoms), VACCINATION COMPLICATION (she felt sick), FEELING COLD (patient had cold in the body) and FATIGUE (fatigue) was resolving. Reporter did not allow further contact


VAERS ID: 1863777 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2020-12-24
Onset:2021-11-03
   Days after vaccination:314
Submitted: 0000-00-00
Entered: 2021-11-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 026L20A / 1 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Vertigo, Vomiting
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (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? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: No medical history was reported
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: Severe vertigo on left side; Severe vomiting,Had to lay down because at upright position she was vomiting;; This spontaneous case was reported by a physician and describes the occurrence of VERTIGO (Severe vertigo on left side) and VOMITING (Severe vomiting,Had to lay down because at upright position she was vomiting;) in a 48-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 039D21A, 026L20A and 026L20A) for COVID-19 vaccination. No medical history was reported. On 24-Dec-2020, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 22-Jan-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 29-Oct-2021, received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 03-Nov-2021, the patient experienced VERTIGO (Severe vertigo on left side) and VOMITING (Severe vomiting,Had to lay down because at upright position she was vomiting;). The patient was treated with MECLIZINE [MECLOZINE] for Vertigo, at an unspecified dose and frequency. On 04-Nov-2021, VOMITING (Severe vomiting,Had to lay down because at upright position she was vomiting;) had resolved. At the time of the report, VERTIGO (Severe vertigo on left side) had not resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No concomitant medication was reported.


VAERS ID: 1863782 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Male  
Location: North Dakota  
Vaccinated:2021-02-26
Onset:2021-11-03
   Days after vaccination:250
Submitted: 0000-00-00
Entered: 2021-11-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 002A21A / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Expired product administered
SMQs:, Medication errors (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: 4 patients were administered vaccines from a vial that has been punctured for greater than 12hours; This spontaneous case was reported by a nurse and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (4 patients were administered vaccines from a vial that has been punctured for greater than 12hours) in a 73-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 014F21A, 045A21A and 002A21A) for COVID-19 vaccination. No Medical History information was reported. On 26-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 26-Mar-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 03-Nov-2021, received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 03-Nov-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (4 patients were administered vaccines from a vial that has been punctured for greater than 12hours). On 03-Nov-2021, EXPIRED PRODUCT ADMINISTERED (4 patients were administered vaccines from a vial that has been punctured for greater than 12hours) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No concomitant medication was provided. No treatment information was provided. Doses were administered from the same vial which was initially punctured on 26-OCT-2021 and administered up until 3-NOV-2021.


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