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From the 10/15/2021 release of VAERS data:

Found 79,643 cases where Location is U.S., Territories, or Unknown and Vaccine is COVID19 and Manufacturer is MODERNA and Standard-MedDRA-Query broadly-matches 'Anaphylactic reaction'



Case Details

This is page 5 out of 7,965

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VAERS ID: 907528 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2020-12-23
Onset:2020-12-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2020-12-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011J20A / 1 UN / IM

Administered by: Work       Purchased by: ?
Symptoms: Chest X-ray, Full blood count, Metabolic function test, Pruritus, Troponin I
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: IV dye, codiene
Diagnostic Lab Data: CBC, CMP, Troponin I, chest xray
CDC Split Type:

Write-up: History to allergic to IVP dye, after the covid vaccine and said felt itchy in face. Patient given dexamethasone 10 mg diphenhydramine 50mg ,epinephrine 0.5 mg and lactated ringers. Patient issue resolved and will be discharged home.


VAERS ID: 907546 (history)  
Form: Version 1.0  
Age: 36.0  
Sex: Female  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2020-12-22
Submitted: 2020-12-22
   Days after onset:0
Entered: 2020-12-23
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Other       Purchased by: Other
Symptoms: Dyspnoea, Headache, Hypoaesthesia, Hypoaesthesia oral, Nasal congestion, Nausea, Pallor, Paraesthesia, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (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: patient had left arm numbness and tingling, lips numbs, and headache at 15 minutes. Symptoms continued to increased headache, SOB, nasal congestion, nausea and vomiting, all extremities numb. face pale.


VAERS ID: 907608 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Alabama  
Vaccinated:2020-12-23
Onset:2020-12-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2020-12-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011J20A / 1 AR / IM

Administered by: Other       Purchased by: ?
Symptoms: Pharyngeal paraesthesia, Rash
SMQs:, Anaphylactic reaction (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: UNKNOWN - SIMILAR REACTION
Other Medications:
Current Illness:
Preexisting Conditions: STATED THAT SHE HAS HAD SIMILAR REACTION IN PAST
Allergies:
Diagnostic Lab Data: NONE - EXTENDED MONITORING AFTER VACCINE
CDC Split Type:

Write-up: MILD RASH, TINGLING IN THRAOT


VAERS ID: 907738 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Connecticut  
Vaccinated:2020-12-22
Onset:2020-12-22
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2020-12-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011J20A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Ear swelling, Erythema, Lip swelling, Pharyngeal erythema
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: protonix, rosuvastatin
Current Illness:
Preexisting Conditions:
Allergies: Fiorinal - shortness of breath iodinated diagnostic agents - anaphylaxis Meperidine - shortness of breath latex - rash penicillins - rash tetracycline - rash
Diagnostic Lab Data:
CDC Split Type:

Write-up: Approximately 35 minutes after patient received the vaccine, she noted redness around her chest and neck, goin up to her face and both ears. Ears were swollen. She was transferred to the ED for evaluation, where it was noted that she had redness of her throat and chest with slight swelling of her lips. In the ED, she was given prednisone 40mg PO and famotidine 40mg PO. She was observed and discharged after ~90 minutes.


VAERS ID: 907769 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Unknown  
Vaccinated:2020-12-22
Onset:2020-12-23
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2020-12-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Fatigue, Injection site pain, Rhinorrhoea, Sneezing
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (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: Moderna COVID-19 Vaccine EUA pain in injection site, fatigue, sneezing, runny nose


VAERS ID: 907811 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Iowa  
Vaccinated:2020-12-23
Onset:2020-12-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2020-12-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025J20 / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Pruritus, Rash macular
SMQs:, Anaphylactic reaction (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: Sertaline 50mg
Current Illness: none
Preexisting Conditions: none
Allergies: morphine
Diagnostic Lab Data:
CDC Split Type:

Write-up: Itchy blotchy spots, left arm, left ear, back


VAERS ID: 907876 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Iowa  
Vaccinated:2020-12-23
Onset:2020-12-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2020-12-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025J20-2A / 1 LA / -

Administered by: Private       Purchased by: ?
Symptoms: Erythema, Feeling hot, Injection site warmth, Skin warm
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: None she is aware of
Diagnostic Lab Data:
CDC Split Type:

Write-up: Shortly after receiving the Moderna COVID-19 Vaccine (Within minutes) she complained of the injection site and that arm of feeling warm. Upon further inspection, her arm was warm to the touch and was red. Patient could feel warmth from inside and we could also feel the warmth with touch. She stayed 15 minutes and we monitored the site. There was no further reaction. The patient had been offered Benadryl and declined. This will be notated for her second dose and will pre-treat with benadryl if needed.


VAERS ID: 907878 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Missouri  
Vaccinated:2020-12-23
Onset:2020-12-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2020-12-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025J20-2A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chest discomfort, Dizziness, Dysphagia, Dyspnoea, Emotional distress, Headache, Limb discomfort, Oxygen saturation normal
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Depression (excl suicide and self injury) (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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient received COVID vaccine at approximately 9AM this morning. Stayed 15 minutes after injection for monitoring, felt fine and returned to department. Employee returned at approximately 11:45AM with possible symptoms of reaction. Admitted to a headache that started approximately an hour after injection. Symptoms now include heaviness of arm, chest, feeling emotional, light headed. Vitals taken at 11:48 BP 150/86, P 79, R16 Pox 97. Oral Benadryl 25mg administered PO 11:50AM. EKG run. Patients symptoms progressed to include difficulty breathing and swallowing. Epi pen adult 0.3mg administered IM Left thigh at 12:13PM. Vitals checked at 12:13PM BP 188/90, pulse 97, pulse ox97. Called for emergency response for transport to ER. Pt remained stable until transport by EMS to ER. Employee health informed of patient transport. ER informed of patient transport.


VAERS ID: 907909 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Missouri  
Vaccinated:2020-12-23
Onset:2020-12-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2020-12-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025J20-2A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Cough, Dry mouth
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: mucolytic
Current Illness: recent history of Clinically diagnosed bronchitis and treated with OTC medication (mucolytic) by pcp
Preexisting Conditions:
Allergies: NKDA
Diagnostic Lab Data: Initial VS: BP: 142/84, HR: 111, RR: 24 Spo2% 99/RA, . End VS: BP: 118/94, HR: 82, RR: 16,, SpO2: 100%/RA. Patient denies shortness of breath or difficulty breathing, Lung sounds are clear. Patient states she feel better and is conscious alert and oriented X4. She was placed in he monitoring room within the vaccination clinic for intermittent monitoring of VS and reaction response at 1317.
CDC Split Type:

Write-up: Patient given covid-19 vaccine at 1218, Symptoms started at 12:25 (dry cough, dry mouth). Benadryl 25mg by mouth given at 1238. No previous history of vaccination reaction. Of note: recent history of Clinically diagnosed bronchitis and treated with OTC medication (mucolytic) by pcp, no ATB given. No NKDA, no recent fever or illness in 24hours. Initial VS: BP: 142/84, HR: 111, RR: 24 Spo2% 99/RA, . End VS: BP: 118/94, HR: 82, RR: 16,, SpO2: 100%/RA. Patient denies shortness of breath or difficulty breathing, Lung sounds are clear. Patient states she feel better and is conscious alert and oriented X4. She was placed in he monitoring room within the vaccination clinic for intermittent monitoring of VS and reaction response at 1317.


VAERS ID: 907916 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2020-12-23
Onset:2020-12-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2020-12-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025J20A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Hives, administered Diphenhydramine 12.5mg po


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