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

Found 334,550 cases where Vaccine targets COVID-19 (COVID19) and Manufacturer is MODERNA

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Case Details

This is page 9 out of 33,455

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VAERS ID: 907535 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: Alaska  
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 / 7+ LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Ear congestion, Fatigue
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:
Other Medications: Phentermine atorvastatin seroquel
Current Illness: none
Preexisting Conditions: carpal tunnel syndrome fatigue pain right hip
Allergies: codeine
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Fatigue, ear congestion


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: 907562 (history)  
Form: Version 1.0  
Age: 33.0  
Sex: Female  
Location: Unknown  
Vaccinated:2020-12-21
Onset:2020-12-21
   Days after vaccination:0
Submitted: 2020-12-22
   Days after onset:1
Entered: 2020-12-23
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 039K20A / 2 RA / -

Administered by: Other       Purchased by: Other
Symptoms: Dizziness, Fatigue, Headache
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:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Headache, lightheadedness, fatigue 5 to 10 min post vaccination


VAERS ID: 907569 (history)  
Form: Version 1.0  
Age: 80.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2020-12-21
Onset:2020-12-23
   Days after vaccination:2
Submitted: 2020-12-23
   Days after onset:0
Entered: 2020-12-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011J20A / UNK LA / -

Administered by: Other       Purchased by: Other
Symptoms: Dyspepsia, Gastrointestinal haemorrhage, Nausea, Vomiting
SMQs:, Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Gastrointestinal haemorrhage (narrow), Gastrointestinal nonspecific dysfunction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Ischaemic colitis (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: 12/23 patient transferred out to acute care hospital for treatment/evaluation of gi bleed. patient does have h/o PPI use that was d/c 5/2020 and no recent gerd symptoms requiring intervention $g60 days. NauseaVomiting, GastricBleeding & heartburn


VAERS ID: 907601 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2019-04-22
Onset:2020-12-23
   Days after vaccination:611
Submitted: 0000-00-00
Entered: 2020-12-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Fatigue, Headache, Pain, 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: n/a
Current Illness: No
Preexisting Conditions: Allergic Fungal Sinusitis
Allergies: Latex and seafood
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Sore arm, body aches, headache, and fatigue.


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: 907623 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Florida  
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 / UNK RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chills, Fatigue, Myalgia, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (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? Yes
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:
CDC Split Type:

Write-up: Chills, fever, fatigue, muscle pain


VAERS ID: 907625 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: New York  
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: Work       Purchased by: ?
Symptoms: Headache, Injection site pain, Neck pain, Pain in extremity
SMQs:, 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: Pristiq
Current Illness: None
Preexisting Conditions: Dysthymia
Allergies: NKDA or other allergies
Diagnostic Lab Data: None at this time
CDC Split Type:

Write-up: Onset about 1 hour after injection with mild left deltoid pain. Then over course of 3 hours developed left arm pain, frontal headache, and posterior neck pain. No rash.


VAERS ID: 907641 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Alaska  
Vaccinated:2020-12-21
Onset:2020-12-22
   Days after vaccination:1
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: Military       Purchased by: ?
Symptoms: Abdominal pain upper, Chills, Headache, Hyperhidrosis, Pain, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: ORAL CONTRACEPTION PILL
Current Illness: NONE CURRENTLY, COVID-19 3 WEEKS PRIOR TO VACCINATION
Preexisting Conditions: NONE
Allergies: NONE
Diagnostic Lab Data: NA
CDC Split Type:

Write-up: HEADACHE, EXCESSIVE CHILLS, EXCESSIVE SWEATING, FEVER, BODYACHES, STOMACHACHE


VAERS ID: 907737 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Montana  
Vaccinated:1969-06-06
Onset:2020-12-22
   Days after vaccination:18827
Submitted: 0000-00-00
Entered: 2020-12-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Immediate post-injection reaction, Injection site induration, Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (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: Synthroid, Lyrica, Benedryl, Melatonin
Current Illness: No
Preexisting Conditions: NO
Allergies: Amoxicillin, Tylenol
Diagnostic Lab Data:
CDC Split Type:

Write-up: Immediate pain in right arm with administration of vaccine. 30 mins after administration noticed shooting pain in to elbow. Shooting pain has continued through today. Also reports palm sized hardness at injection site.


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