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

Found 79,047 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 7 out of 7,905

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VAERS ID: 908071 (history)  
Form: Version 2.0  
Age: 32.0  
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 011J20A / 1 AR / IM

Administered by: Private       Purchased by: ?
Symptoms: Anxiety, Chills, Dizziness, Dyspnoea, Nausea, Paraesthesia, Rash, Tremor
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypersensitivity (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? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies: IODINE - ANAPHYLAXIS
Diagnostic Lab Data:
CDC Split Type:

Write-up: hand shaking, chills, rash, nausea, lightheadedness ? reports hard to take a deep breath, given diphenhydramine 50 mg PO x 1 @ 10:15 in clinic and an additional 25 mg PO x 1 @ 10:30 in the clinic. Symptoms persisted - pt anxious - taken to ED for evaluation. After 10-15 minutes in ED, her symptoms subsided ? she only had mild tingling in the left hand along with two red spots on the back of her neck. Given prednisone 50 mg PO x 1 in ED. observed in ED for 2 hours ? pt feels much better ? pt felt comfortable going home ? told to continue to take Benadryl and prednisone for next 3 days. Instructions given to return to ED for any worsening of symptoms. Rx with Prednisone 50 mg daily x 3


VAERS ID: 908103 (history)  
Form: Version 2.0  
Age: 55.0  
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 - / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Erythema, Fatigue, Nausea, Pain, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), 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: Localized pain, redness
Other Medications: Levothyroxine 125.Mcg daily Aleve 220 mg Bid Multivitamin with zinc daily Tramadol 50 mg Tid Fish oil 2000 mg daily Famotidine 20 mg Bid Lisinopril 20 mg daily Atorvastatin 20 mg daily
Current Illness: Covid + 11/15/20-hospitalized d/t dehydration and covid pneumonia
Preexisting Conditions: Graves disease Hypertension Hyperlipidemia Spondylitis with chronic back pain Gerd q
Allergies: Amoxicillin- hives
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Nausea Vomiting Fatigue


VAERS ID: 908175 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Florida  
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 039K20A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Headache, Injection site erythema, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (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: Multi vitamin
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Headache, redness below injection site, mild swelling


VAERS ID: 908212 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Tennessee  
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 - / UNK - / SYR

Administered by: Public       Purchased by: ?
Symptoms: Eye swelling, Lip swelling, Migraine, Oral mucosal blistering, Oropharyngeal discomfort, Paraesthesia, Pruritus, Swelling face, Swollen tongue
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (narrow), Angioedema (narrow), Peripheral neuropathy (broad), Oropharyngeal allergic conditions (narrow), 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? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None that I know of
Preexisting Conditions: None
Allergies: Latex, codeine, sulfa
Diagnostic Lab Data:
CDC Split Type:

Write-up: Edit: about an hour after my vaccine I began itching on my neck and got a scratchy throat. Then felt blisters in my mouth and felt a tingly feeling on my face. I had swelling in my eyes, jaw, lips, nose and tongue. And hives on my neck and chest. I went to my local ER and was given IV PEPCID, benedryl and a steriod. Swelling came down significantly and I was discharged home after about 2 hours with a steroid dose pack, Claritin and Pepcid. I now have a strong migraine.


VAERS ID: 908216 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Oklahoma  
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 RA / IM

Administered by: Other       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? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: Potassium
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient reports allergy to potassium as itching with a history of hives. Patient was aware of the risk vs benefit and potential of ADE due to allergies prior to receiving the vaccine. Patient was observed for 30 minutes. Patient experienced itching about 25 minutes post vaccine. Diphenhydramine 25mg was given to patient.


VAERS ID: 908218 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Oklahoma  
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: Arthralgia, Chills, Dyspnoea, Fatigue, Headache, Myalgia, Nausea, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Arthritis (broad), 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: Prozac 10mg PO QDAY
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: NKDA
Diagnostic Lab Data:
CDC Split Type:

Write-up: Shortness of breath, fatigue, headache, muscle pain, joint pain, chills, nausea, fever


VAERS ID: 908627 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Washington  
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 037K20A / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Body temperature increased, Ear pruritus, Pruritus, Rash, Throat irritation
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (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? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Depo Provera; Hydrocodone, steroid injection 12/21/20
Current Illness: Bicuspid Aortic valve, torn perineal longus tendon (R) Foot
Preexisting Conditions: see above
Allergies: Sulfa iodine, codeine, PCN, Metoprolol
Diagnostic Lab Data:
CDC Split Type:

Write-up: Appoximately 12:15pm patient Reporting itching all over her body, throat feeling scratchy, bumps forming on chest, ear itching. Vital signs taken Benedryl 12.5 mg given IM x2. pepcid given orally, continued to monitor x 60 min. Itching was Reduced over body, bumps on skin Resolved. Temperature Rose from 97.2F to 99.4F.


VAERS ID: 908661 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Arizona  
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 011J208 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Dizziness, Flushing
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Vestibular disorders (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: Morning meds taken @ 9am
Current Illness: UTI week 12/14
Preexisting Conditions: Asthma, HTN, Type II DM, Anxiety, Depression
Allergies: Effexor, gabapentin, Pineapples, walnuts, cephlosporins, Wellbutrin, neosporin
Diagnostic Lab Data: PT was sent to ER.
CDC Split Type:

Write-up: Pt reports feeling dizzy and lightheaded & flush about 30-45 mins after vaccination. Pt reports that flush feeling resolved after 30 min however the dizziness & lightheadedness persisted. Pt ate lunch and did not feel any better and reported s/s to staff v/s were taken and were stable. Pt was given water and brought to lay down for continued observation


VAERS ID: 908662 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Arizona  
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 011J2OA / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Dysgeusia, Flushing
SMQs:, Anaphylactic reaction (broad), Taste and smell disorders (narrow), 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: pristiq, crestor, lyrica, zyrtec, desmopressin, bystolic
Current Illness: none
Preexisting Conditions: arrythmias, high cholesterol,
Allergies: penicillin, gentamicin,
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Pt was seated and suddenly became flushed and reported a strange taste in her mouth. Vitals taken. BP 116/65, pulse 87, O2 99%. Pt given water and continued to observe. Pt reported feeling better.


VAERS ID: 910020 (history)  
Form: Version 1.0  
Age: 53.0  
Sex: Female  
Location: Unknown  
Vaccinated:2020-12-23
Onset:2020-12-23
   Days after vaccination:0
Submitted: 2020-12-23
   Days after onset:0
Entered: 2020-12-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 039K20A / 2 LA / -

Administered by: Other       Purchased by: Other
Symptoms: Injection site urticaria
SMQs:, Anaphylactic reaction (broad), 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:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: had hives on back and L arm 1 inch medial to vaccine injection site; no lip or tongue edema, no wheezing or stridor Treatment dugs:


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