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

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



Case Details

This is page 6 out of 8,076

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VAERS ID: 907922 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Puerto Rico  
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 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Cough, Dyspnoea
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: ASTHMA
Preexisting Conditions:
Allergies: Seafood
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient reports shortness of breath and persistent cough.


VAERS ID: 907936 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Male  
Location: Ohio  
Vaccinated:2020-12-23
Onset:2020-12-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2020-12-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011J20A / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Chest discomfort, Dyspnoea, Flushing
SMQs:, Anaphylactic reaction (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (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: N/A
Current Illness: None known
Preexisting Conditions: None known
Allergies: None previously known
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient became flushed, chest tightness and felt winded. BP was 130/70 and 02 saturation was 100%. Patient had not tongue swelling, previous reaction to a vaccine, medication or food and no shortness of breath. Patient was placed on gurney for 30 minutes and had no further symptoms after this time.


VAERS ID: 907943 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Colorado  
Vaccinated:2020-12-23
Onset:2020-12-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2020-12-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011J20A / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Pruritus, 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? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Thyroxine
Current Illness: None
Preexisting Conditions: Hypothyroidism
Allergies: None
Diagnostic Lab Data: NA
CDC Split Type:

Write-up: 1 hr post administration patient developed urticaria, pruritus


VAERS ID: 907963 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Male  
Location: Tennessee  
Vaccinated:2020-12-01
Onset:2020-12-23
   Days after vaccination:22
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: Public       Purchased by: ?
Symptoms: Erythema, Paraesthesia
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (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: Atorvastatin Tylenol Baby ASA Vitamin D Vitamin B12 Preservision
Current Illness: None
Preexisting Conditions: None
Allergies: NKA
Diagnostic Lab Data: None
CDC Split Type:

Write-up: 11 am started noticing tingling in Right side of face. Then redness on ry neck below jaw and tingling on left side of face and left side of body. Lasting for 1 hour


VAERS ID: 907971 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: South Dakota  
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 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Pruritus
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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNKNOWN
Current Illness: NONE
Preexisting Conditions: NONE
Allergies: NKDA
Diagnostic Lab Data:
CDC Split Type:

Write-up: EXTREME BILATERAL ITCHING ON BOTH ARMS THROUGHOUT


VAERS ID: 907979 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: North Carolina  
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 011520A / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chest discomfort, Dizziness, Flushing, Injection site pain, Palpitations, Vertigo
SMQs:, Anaphylactic reaction (narrow), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Extravasation events (injections, infusions and implants) (broad), Cardiomyopathy (broad), Vestibular disorders (narrow), Hypersensitivity (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: Concerta, Zyrtec, Flonase
Current Illness: None
Preexisting Conditions: ADD, Raynaud''s, IBS-D, Endometreosis, Depression/Anxiety
Allergies: Penicillin- anaphylaxis, Reglan- akathisia
Diagnostic Lab Data: None, observation
CDC Split Type:

Write-up: First 30 min post-vaccine: flushing and lightheaded, self limiting. 1.5 hours post-vaccine: vertigo x10 minutes, palpitations, chest tightness. Palpitations were brief and at rest. BP 172/110, HR 95, O2 Sat 99% on RA. 2.5 hours post-vaccine: chest tightness has remained constant with mild restrictive sensation on full inhale, vertigo returned but briefer in duration, BP 173/100, HR 85, Temperature 98.5F, O2 Sat 97% with decrease during conversation. 3 hours post-vaccine: lightheaded with constant chest tightness, BP 168/110, HR 88, O2 Sat 98% on RA, 6 hours post-vaccine: symptoms resolved, BP 148/100, injection site burns and sore to touch.


VAERS ID: 908031 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: New Mexico  
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 039K20 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Pruritus, 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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: asthma
Allergies: Penicillin, honeydew melon
Diagnostic Lab Data:
CDC Split Type:

Write-up: hives, pruritus within 30 minutes


VAERS ID: 908044 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Michigan  
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 - / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Obstructive airways disorder, Oral pruritus, Respiratory distress
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Asthma/bronchospasm (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Respiratory failure (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? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: HEP A
Other Medications: UNKNOWN
Current Illness: COVID + 12/8/20
Preexisting Conditions: UNKNOWN
Allergies: YES (HEP A VACCINE, TREE NUTS)
Diagnostic Lab Data:
CDC Split Type:

Write-up: PT WAS ADMINISTERED MODERNA VACCINE AT HD ON 12/23 AROUND 1540. PT HAS EXTENSIVE HISTORY OF ALLERGIC REACTIONS (HEP A VACCINE AND TREE NUTS). PT ALSO COVID + ON 12/8/20 . HX REVIEWED WITH HD RN PRIOR TO ADMINISTERING. PT WAS ADVISED TO WAIT 30 MIN IN WAITING ROOM. EMS STAFF ON SITE FOR CLINIC. PT STARTED COMPLAINING OF "ITCHY MOUTH" AROUND 1620 AT WHICH POINT EMS ATTEMPTED TO ESCORT PT TO PERSONAL VEHICLE TO DRIVE HER TO LOCAL ED. PT MADE IT TO THE THE VEHICLE BUT DEVELOPED INCREASED RESPIRATORY DISTRESS AND AIRWAY RESTRICTION. AMBULANCE WAS CALLED. EMS ADMISNTERED .3ML EPI AT 1631 AND APPLIED 8L O2 VIA MASK. ABUMBULACE ARRIVED AT 1636. PT TAKEN TO LOCAL ED VIA AMBULANCE


VAERS ID: 908050 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Female  
Location: Missouri  
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 AR / IM

Administered by: Work       Purchased by: ?
Symptoms: Injection site reaction, Rash, Rash erythematous, Rash papular
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? 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: none
CDC Split Type:

Write-up: localized raised red rash at injection site - given diphenhydramine 25 mg PO x1 - increased monitoring for 30 minutes. Patient still had rash but it was improved. Was able to leave clinic to home


VAERS ID: 908062 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Nebraska  
Vaccinated:2020-12-23
Onset:2020-12-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2020-12-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011J20A / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Haemoglobin normal, Hypersensitivity, Rash, Red blood cell count normal, Throat tightness, White blood cell count normal
SMQs:, Anaphylactic reaction (narrow), Angioedema (broad), 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Results Units Reference Range White Blood Cell Count 9.01 10*3/uL 3.80-10.80 (10*3/uL) Red Blood Cell Count 4.58 10*6/uL 3.93-6.00 (10*6/uL) Hemoglobin 13.8 g/dL 12.0-18.0 (g/dL
CDC Split Type:

Write-up: Age: 43 years 12/23/2020 12:21 Chief Complaint: ALLERGIC REACTION History of Presenting Illness: This 43 yo female presents from specialty clinic for an allergic reaction. Patient has just received the Moderna Sars-Cov2 vaccine. She has had covid in the past, and her Igg tested outpatient was positive at 5.2 (per patient). She had received the vaccine at 11, and says that she usually has a reaction to vaccinations and drugs. She began having some rash around the neck and felt like her throat was closing. She was brought to the emergency room.


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