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

Found 309,258 cases where Vaccine targets COVID-19 (COVID19) and Manufacturer is MODERNA



Case Details

This is page 7 out of 30,926

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VAERS ID: 907390 (history)  
Form: Version 1.0  
Age: 64.0  
Sex: Female  
Location: Unknown  
Vaccinated:2020-12-22
Onset:2020-12-22
   Days after vaccination:0
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 039K20A / 2 LA / -

Administered by: Other       Purchased by: Other
Symptoms: Nasal pruritus, Oral pruritus, Pruritus, Vaccination complication
SMQs:, Anaphylactic reaction (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), 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? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: 64y/o FEMALE presents to the ED for evaluation of facial itching after COVD vaccine in left arm. The patient states shortly after the vaccine (about 10 minutes) her nose and mouth started itching. She was given PO Pepcid and IM Benadryl PTA in ED. She denies any associated SOB, nausea vomiting wheezes or near syncope. Denies fever/chills, n/v/d or other complaints at this time. IMPRESSION/PROBLEM LIST:---------------------1. Adverse Reaction to Vaccine for COVID


VAERS ID: 907391 (history)  
Form: Version 1.0  
Age: 37.0  
Sex: Female  
Location: Unknown  
Vaccinated:2020-12-22
Onset:2020-12-22
   Days after vaccination:0
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 039K20A / 2 LA / -

Administered by: Other       Purchased by: Other
Symptoms: Dyspnoea, Pallor, Periorbital swelling
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Periorbital and eyelid disorders (narrow), Hypotonic-hyporesponsive episode (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? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: 37y/o FEMALE doctor was brought to the ER via gurney from the vaccination area after getting Covid 19 vaccination, patient felt SOB, buffy eye and become pale, she took immediately Claritin and Pepcid, patient was brought to the ER. she denied light headedness. Swelling of lips or the tongue. IMPRESSION --------------------Adverse reaction to the Covid 19 Vaccination-Resolved


VAERS ID: 907395 (history)  
Form: Version 1.0  
Age: 44.0  
Sex: Male  
Location: Unknown  
Vaccinated:2020-12-22
Onset:2020-12-22
   Days after vaccination:0
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 039K204 / 2 RA / -

Administered by: Other       Purchased by: Other
Symptoms: Dizziness, Nausea, Tachycardia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Dehydration (broad)

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

Write-up: 44 y/o MALE doctor with no hx of allergic reaction with previous vaccination was brought to the ER from the vaccination area, patient stated he become tachycardic, dizzy and nauseated 10 min after the vaccination shot was given. Patient denied rash, SOB, wheezing or Swelling of the face and the tongue. Benadryl & Zofran given 1.Adverse Reaction to Vaccination-resolved


VAERS ID: 907410 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Colorado  
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 025J20-2A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Abdominal distension, Anxiety, Blood pressure increased, Dizziness, Dysphagia, Eructation, Palpitations, Tachycardia, Tunnel vision, Urticaria
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypertension (narrow), Optic nerve disorders (broad), Cardiomyopathy (broad), Retinal disorders (narrow), Vestibular disorders (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (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: birth control
Current Illness: cold
Preexisting Conditions:
Allergies: snake venom
Diagnostic Lab Data:
CDC Split Type:

Write-up: Medical History: severe anaphylactic shock requiring intubation related to rattlesnake bite August 2019. On September 2019, I went to the dentist and received septacaine, mouth and face swelled up immediately. Toxicologist said this was due to me still being in a "cytokine storm." 12/22/2020- I received my COVID-19 vaccine by Moderna. Within 5 minutes of me receiving the vaccine I first experienced tachycardia, felt my heart pounding, dizziness, and tunnel vision. Three hives, dime sized, appeared on my chest within 10 minutes of the vaccine. I felt difficulty swallowing (may have been anxiety related). The dizziness was intermittent for the next hour. I took 25 mg of Benadryl 15 minutes after the shot. My blood pressure was elevated for an hour, 170s/100 s, Osat maintained above 94%, and heart rate 80s-90s. My resting HR and BP are 100s/60 and HR 61. I also started to feel bloated and burping. An hour and a half after the shot, the symptoms resolved and I drove home


VAERS ID: 907421 (history)  
Form: Version 2.0  
Age: 36.0  
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: Dizziness, Dyspnoea, Flushing
SMQs:, Anaphylactic reaction (narrow), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Zinc, Vitamin C, Multi Vitamin
Current Illness: None
Preexisting Conditions: No
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Dizziness, Flush, Shortness of Breath


VAERS ID: 907423 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Arizona  
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: Asthenia, Chest X-ray, Computerised tomogram head, Dyspnoea, Electrocardiogram, Hypoaesthesia, Laboratory test, Nausea, Pregnancy test, Speech disorder, Swollen tongue
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (narrow), Peripheral neuropathy (broad), Dementia (broad), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Psychosis and psychotic disorders (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (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? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: Laparoscopic Cholecystectomy on 11-6-2020
Preexisting Conditions: None
Allergies: Keflex and Tramadol
Diagnostic Lab Data: CT of head, routine labs, chest x-ray, pregnancy test, neurology consulting, EKG
CDC Split Type:

Write-up: Onset of symptoms began approximately 1.5 hours after vaccination. Patient became weak c/o tongue swelling, nausea, difficulty breathing, numbness especially in lower extremities. Felt she couldn''t breath, numbness continued to get worse and affected her upper extremities as well, weak speech.


VAERS ID: 907424 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Male  
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 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chills, Fatigue, Injection site pain, Nasal congestion, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (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: Tdap, sore arm
Other Medications: Tylenol in the AM prior to vaccine
Current Illness: Mild respiratory congestion
Preexisting Conditions: idiopathic thrombocytopenic
Allergies: N/A
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Injection site aching, chills, body aches, fatigue, tiredness, nasal congestion. 12/23/2020 in AM All symptoms starting to resolve - feeling better; Nasal congestion, Fever 102.1, Tylenol and Ibuprofen some relief; fever at time of reporting 100.5.


VAERS ID: 907425 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Male  
Location: Unknown  
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: Private       Purchased by: ?
Symptoms: Hypoaesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Sexual dysfunction (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: ompezrole as needed Zyrtec as needed
Current Illness: none
Preexisting Conditions: GERD
Allergies: NKDA
Diagnostic Lab Data: none
CDC Split Type:

Write-up: The patient was doing great. After 30 min later, the pt started to have numbness on the face. Felt like the face was completely numb. Came back to clinic and numbness started to go away. It would wax and wane. It started to improve. Now the patient is doing great. Other vitals fine. NO SOB, No intervention done. Pt released home.


VAERS ID: 907431 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Male  
Location: New York  
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 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood glucose increased, Chest X-ray normal, Electrocardiogram, Glycosylated haemoglobin decreased, SARS-CoV-2 test negative, Tachycardia
SMQs:, Hyperglycaemia/new onset diabetes mellitus (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dehydration (broad), 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:
Other Medications: None
Current Illness: None
Preexisting Conditions: HTN, DM
Allergies: NKDA
Diagnostic Lab Data: Glucose 226 CXR normal HGBA1C 8.7 EKG COVID Negative on 12/22/2020
CDC Split Type:

Write-up: Tachycardia, rate 135


VAERS ID: 907437 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Male  
Location: Unknown  
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 O11J20A / UNK - / -

Administered by: Public       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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient began with hives and itching all over. Patient given 50mg IM Benadryl Patient watched for 40 minutes. All sx improved.


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