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VAERS_ID | RECVDATE | STATE | AGE_YRS | CAGE_YR | CAGE_MO | SEX | RPT_DATE | SYMPTOM_TEXT | DIED | DATEDIED | L_THREAT | ER_VISIT | HOSPITAL | HOSPDAYS | X_STAY | DISABLE | RECOVD | VAX_DATE | ONSET_DATE | NUMDAYS | LAB_DATA | V_ADMINBY | V_FUNDBY | OTHER_MEDS | CUR_ILL | HISTORY | PRIOR_VAX | SPLTTYPE | FORM_VERS | TODAYS_DATE | BIRTH_DEFECT | OFC_VISIT | ER_ED_VISIT | ALLERGIES | Link 1 | Link 2 |
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0935111 | 01/11/2021 | WI | 81.0 | 81 | M | VACCINE ADMINISTERED AROUND 11 AM. NURSE DISCOVERED A LARGE HOT RED 2 INCH PATCH ON HIS LEFT CHEEK (98.2 DEGREES). THERE WAS A OVER A DEGREE DIFFERENCE IN TEMPERATURE FROM RIGHT CHEEK TO LEFT CHEEK (97. - ISH DEGREES) THERE WAS ALSO A SMALL AREA ON THE | Y | 01/08/2021 | 01/08/2021 | 0 | NONE | SEN | SUPPLEMENT SHAKE, PROHEAL PROTEIN SUPPLEMENT, HYDROCORTISONE 10MG TAB, ASA 81MG, VIT D 1000 UNIT, LEVOTHYROXINE 112MCG, METFORMEN 500MG, METOPROLOL 25MG, MULTIVITAMIN, PROTONIX 20MG, | ADMITTING DIAGNOSIS WAS UNILATERAL PRIMARY OSTEOARTHRITIS OF THE RIGHT KNEE | OSTEO ARTHRITIS, DEMENTIA, CONGESTIVE HEART FAILURE, TYPE 2 DIABETES, TACHYCARDIA, HYPERLIPIDEMIA, ESSENTIAL HYPERTENSION, HYPEROSMOLALITY AND HYPERNATREMIA, | 2 | 01/11/2021 | Y | NONE | 2021VAERSSYMPTOMS | 2021VAERSVAX | 0947843 | 01/15/2021 | WI | 81.0 | 81 | F | Resident began having a general decline in condition on 1/8/21 and continued to decline until her passing on 1/10/21. | N | 12/29/2020 | 01/08/2021 | 10 | SEN | Metoprolol, Ferrex, Hydroxychloroquine, Calcitriol, Fluticason,Loperamide, Levothyroxine, Famotdine, Amlodipine, ES Tylenol, Prednisone, Slow-Magnesium | Sepsis, Chronic Kidney Disease, A-Fib, Nonrheumatic aortic val valve stenosis, Crohn's Disease | See above | 2 | 01/15/2021 | Penicillins, Estrogens, Estrogens, Conjugated, Codeine, Epen, Epinepherine, Raloxifene HCl, Warafrin, Hydrochlorothiazide, Lasix, Triamterene, Cephalexin, Sulfas, Azathioprine, Clarithromycin, Zolpidem Tartrate, Alendronate Sodium | 2021VAERSSYMPTOMS | 2021VAERSVAX | 0980352 | 01/28/2021 | WI | 81.0 | 81 | M | Acute pancreatitis; Acute renal failure; Low blood pressure; Weakness; Decreased appetite; Fatigue; Alanine aminotransferase increased; Aspartate aminotransferase increased; Troponin increased; Lipase increased; Blood bilirubin increased; A spontaneous rep | Y | 3 | Y | 01/05/2021 | 01/08/2021 | 3 | Test Date: 20210111; Test Name: alanine transaminase; Result Unstructured Data: significantly elevated; Test Date: 20210111; Test Name: aspartate transaminase; Result Unstructured Data: significantly elevated; Test Date: 20210111; Test Name: bilirubin; Res | UNK | Dementia (Advanced); Heart disease, unspecified; Living in nursing home | Medical History/Concurrent Conditions: Leukemia NOS (Possible); Pulmonary embolism | USMODERNATX, INC.MOD20210 | 2 | 01/27/2021 | 2021VAERSSYMPTOMS | 2021VAERSVAX | 0983294 | 01/28/2021 | WI | 81.0 | 81 | M | Patient had full body hives starting on 1/25/2021 (mainly on arms) Hoarseness in throat and congestion Child treated with Benadryl Advised treatment from PCP was/is as of 1/28/2021 Zyrtec 10 mg AM + pepcid 20 mg AM Zyrtec 10 mg PM + pepcid 20 mg PM L | Y | 01/25/2021 | 01/25/2021 | 0 | none | PVT | Monurol 3gm weekly (was taken the day of the vaccine), DiltiaZem 120 mg BID, Furosemide 40 mg daily, Toprol XL 100 mg 1 tablet daily, Donepezil 5mg (2 tablets nightly), Namenda, Sertraline 50 mg, Vitamin B12 500 mcg daily, Vitamin C 1000 m | none | Problem List Endocrine IFG (impaired fasting glucose) Cardiovascular Syncope Paroxysmal atrial fibrillation (*) Nonrheumatic mitral valve regurgitation Mitral regurgitation Left ventricular enlargement Left atrial enlargement History of atrial fibrillation | 2 | 01/28/2021 | Penicillin's Penicillin G Sulfa Antibiotics Heparin | 2021VAERSSYMPTOMS | 2021VAERSVAX | 0998780 | 02/03/2021 | WI | 81.0 | 81 | M | pt states after taking the vax he woke up with headache and sinus congestion. After getting up next morning he noticed a numbness on the left side of his face, mouth and teeth. He got a tingling sensation that moved from his arm down into his thumb and | Y | 02/01/2021 | 02/02/2021 | 1 | none | PVT | IBU | none | none | 2 | 02/03/2021 | none | 2021VAERSSYMPTOMS | 2021VAERSVAX | 1002848 | 02/04/2021 | WI | 81.0 | 81 | F | Patient reported systemic urticaria beginning approximately 5 hours following vaccination. Patient medicated with dose of diphenhydramine and symptoms abated soon thereafter with no further reported effects. | Y | 01/27/2021 | 01/27/2021 | 0 | PUB | 2 | 02/04/2021 | 2021VAERSSYMPTOMS | 2021VAERSVAX | 1016157 | 02/09/2021 | WI | 81.0 | 81 | M | 1/20 i was tired for about 2 hrs. 1/21 I had a little different bowel movements . about 8 days later. started to get a little wobbly getting out of chair. 3 days later i had to use a cane to get around. and then the next morning i was fine. | Y | 01/19/2021 | 01/20/2021 | 1 | PVT | 2 | 02/09/2021 | 2021VAERSSYMPTOMS | 2021VAERSVAX | 1027386 | 02/12/2021 | WI | 81.0 | 81 | F | patient started to experience uncontrollable twitching of arms and legs and severe flushing of face aprox 15 minutes after vaccine administration | U | 02/12/2021 | 02/12/2021 | 0 | none known | PHM | Coumadin,losartan,amlodipine | none | HBP | Tdap 10/2018 excessive swelling in arm of administration | 2 | 02/12/2021 | Y | none | 2021VAERSSYMPTOMS | 2021VAERSVAX | 1032959 | 02/16/2021 | WI | 81.0 | 81 | F | Took a Tylenol for discomfort | Y | 01/31/2021 | 01/31/2021 | 0 | None | PUB | Hydroxyzine 10mg Tylenol 500 3 x day Restasis 2xday Pain pump with dilaudid and bupivocaine Diclofenac gel | Back pain | 2 | 02/16/2021 | Sulfa Emycin | 2021VAERSSYMPTOMS | 2021VAERSVAX | 1036281 | 02/17/2021 | WI | 81.0 | 81 | M | feet and lower leg became very red and very itchy in the night. by morning only toes blotchy red and itch gone. | Y | 02/15/2021 | 02/16/2021 | 1 | PVT | xaralto, allopurinol, vitd, calcium, multi vit, metoprilol, lysinopril, baby aspirin | back pain | has a pace maker, high blood pressure, back pain,gout at times, | 2 | 02/17/2021 | none | 2021VAERSSYMPTOMS | 2021VAERSVAX | 1042003 | 02/19/2021 | WI | 81.0 | 81 | F | Severe L-sided Bell's Palsy, onset 2/15/2021. . Per CDC recommendations we are reporting this to VAERS. | N | 01/31/2021 | 02/15/2021 | 15 | Evaluation in ER 2/17/2021 | PVT | amlodipine, aspirin, calcium supplement, multivitamin, Tums, vitamin-D, zinc | none significant | essential hypertension, GERD | 2 | 02/19/2021 | Y | Y | amoxicillin (rash of unclear severity) | 2021VAERSSYMPTOMS | 2021VAERSVAX | 1046252 | 02/22/2021 | WI | 81.0 | 81 | F | A few hours after the vaccine, came home and got a headache, then she got nausea. She went to bed, and all night and into the next day had fever/chills. She got up during the night to get some water she collapsed and could not get up as she was so weak. | Y | 02/18/2021 | 02/18/2021 | 0 | None. | OTH | Centrum one a day. | None. | None. | 2 | 02/22/2021 | None. | 2021VAERSSYMPTOMS | 2021VAERSVAX | 1051268 | 02/24/2021 | WI | 81.0 | 81 | M | Possible Stroke; Increase pressure and numbness in fingers; Headache; A spontaneous report was received from a pharmacist concerning an 81-year old male patient, who received Moderna's COVID-19 Vaccine (mRNA-1273) and experienced possible stroke, face numb | Y | U | 02/02/2021 | 02/10/2021 | 8 | UNK | XANAX; HYDROXYZINE | Medical History/Concurrent Conditions: No adverse event (No reported medical history.) | USMODERNATX, INC.MOD20210 | 2 | 02/23/2021 | 2021VAERSSYMPTOMS | 2021VAERSVAX | 1054586 | 02/25/2021 | WI | 81.0 | 81 | M | The patient developed sudden onset nausea, diaphoresis and hypotension and shaking. Symptoms improved with IV fluids and rest. She was hospitalized 2 days. | Y | 2 | U | 02/03/2021 | 02/22/2021 | 19 | She was found to have an elevated d-dimer without pulmonary embolism or DVT identified. | UNK | docusate sodium, multivitamin, paroxetine, risperidone, trazodone, albuterol, ketoconazole shampoo, psyllium wafer | 1. Diastolic dysfunction 2. Anxiety with depression 3. Obstructive sleep apnea 4. Major neurocognitive disorder and mood disorder with psychotic features. 5. Frontotemporal dementia, following with neurology and underwent neuro-psych evaluation in fall 20 | 1. Diastolic dysfunction 2. Anxiety with depression 3. Obstructive sleep apnea 4. Major neurocognitive disorder and mood disorder with psychotic features. 5. Frontotemporal dementia, following with neurology and underwent neuro-psych evaluation in fall 20 | 2 | 02/25/2021 | doxycycline, ibuprofen, levaquin, morphine, penicillin, cephalexin, tolmetin | 2021VAERSSYMPTOMS | 2021VAERSVAX | 1062457 | 03/01/2021 | WI | 81.0 | 81 | M | Patient admitted for fatigue, dry throat, generalized weakness, dyspnea on exertion. Durion hospitalization was identified to have an acute ischemic CVA -- unclear time of symptom onset, possibly evening of 2/9 or morning of 2/10. Time course suspicious fo | Y | Y | 3 | U | 02/02/2021 | 02/09/2021 | 7 | PUB | acetaminophen alprazolam Execdrine Hydroxyzine ibuprofen | 2 | 03/01/2021 | NKDA | 2021VAERSSYMPTOMS | 2021VAERSVAX | 1069114 | 03/03/2021 | WI | 81.0 | 81 | F | immediately after vaccine injection upper body went into convulsion, uncontrolled jerking and tremor of all extremities. Difficulty Breathing | N | 02/12/2021 | 02/12/2021 | 0 | EKG, Thiroid Scan, Lung X-Ray, Blood Work, Urin Test, 4 hrs Observation at this facility | PHM | Losartan 50 mg, Amlodipine 2mg, Warfarin 4mg Multi Vitamin, Potassium, Fish Oil Omega 3, Vitamin D3, Glucosamine + Chondroitin Sulfate, Lutein + Zeaxanthion. | chronic Afib, Ostero Arthritis | Heart Arrhythmia, chronic Afib | Tdap | 2 | 03/03/2021 | Y | Y | Sensitive to all medication, Anaphylactic Shock to Bee Sting and Penicilline in combination with Streptomicine | 2021VAERSSYMPTOMS | 2021VAERSVAX | 1074258 | 03/05/2021 | WI | 81.0 | 81 | F | Patient developed macular, erythematous, burning rash of the neck, trunk, and extremities about 10 hours after the vaccine. No urticaria. No wheezing. No oral or ocular lesions. No GI or GU symptoms. No fever. No myalgia. No fatigue. | U | 03/04/2021 | 03/04/2021 | 0 | CBC, Comp Met Panel, Tryptase, ANA, C4 | PUB | Ceftin, Lopressor, Norvasc, TMP, Pravastatin, Prilosec, Vitamin C, Colace, Zyrtec, Caltrate+D | UTI | CKD, Breast CA, GERD, OA, RLS, HTN, Hiatus Hernia | 2 | 03/05/2021 | Y | Sulfa, Macrobid, PCN, Tramadol, Solifenacin | 2021VAERSSYMPTOMS | 2021VAERSVAX | 1077758 | 03/06/2021 | WI | 81.0 | 81 | M | Per neurology consult: "Patient was at his baseline until when he received his 2nd dose of SARS-CoV-2 vaccination. He complained of dyspnea and fear of impending doom after waking up the following morning with some disorientation. He was found to be in A | Y | Y | U | 03/01/2021 | 03/02/2021 | 1 | PVT | 2 | 03/06/2021 | 2021VAERSSYMPTOMS | 2021VAERSVAX | 1110126 | 03/18/2021 | WI | 81.0 | 81 | F | Pt states she received vaccine around 10am. States "it ached going in and then was ok until noon". Reports she took Ibuprofen with no effect. States left arm "ached" and rated pain 8/10 at that point. Reports she took a 45 minute nap and after waking, coul | Y | 03/09/2021 | 03/09/2021 | 0 | None | PUB | Unknown | Unknown | Unknown | 2 | 03/18/2021 | None | 2021VAERSSYMPTOMS | 2021VAERSVAX | 1111472 | 03/18/2021 | WI | 81.0 | 81 | M | I?m 81 years old and had my first Moderna Covid-19 vaccination on March 4th. Within a few days I developed a continuous very high pitch ring in both ears. I had never experienced this before, and thought it would go away. Then I asked my wife why she thoug | N | 03/04/2021 | 03/06/2021 | 2 | None | PVT | Lisinopril 20mg Hydrochlorothiazide 25mg Simastatin 40 Amlodipine 10 Aspirn 81mg | None | None | 2 | 03/18/2021 | None | 2021VAERSSYMPTOMS | 2021VAERSVAX | 1118522 | 03/20/2021 | WI | 81.0 | 81 | F | A week after the first dose, I experience Tintinis. I thought my hot water heat was amiss because I heard a gurgling sound like water rushing through the pipes. I have heard a loud rushing sound and also a sound of high frequency. The sound seem to rota | N | 01/30/2021 | 02/08/2021 | 9 | My ear doctor did not care how my Tintinis started?just that I had it. | SCH | Latanoprost 0.005%. Aspirin. 81 MC. 3x a week Levothyroxine 50MCG. Calcium Citrate Vitamin. 1 daily Simvastatin 10 MG. Cholecalciferol. 1 daily Timolol Maleate 0.5%. Multiple | - | - | 2 | 03/20/2021 | Y | Sulfa | 2021VAERSSYMPTOMS | 2021VAERSVAX | 1126678 | 03/23/2021 | WI | 81.0 | 81 | M | Patient developed COVID-19 symptoms and tested positive on 3/21/2021 after getting vaccinated on 3/20/2021. Patient has a history of COVID - he tested positive on November 16 of 2020. Patient's records also list "Acute respiratory failure with hypoxia ( | Y | U | 03/20/2021 | 03/21/2021 | 1 | UNK | Prednisone, albuterol, Eliquis, atorvastatin, PriLOSEC | Coronary atherosclerosis, | Chronic kidney disease, history of skin cancer, hypertension, DM type 2, GERD, hyperlipidemia | 2 | 03/23/2021 | Tramadol, Rosuvastatin, Penicillins, Atorvastatin | 2021VAERSSYMPTOMS | 2021VAERSVAX | 1138122 | 03/26/2021 | WI | 81.0 | 81 | F | Hospitalization within 6 weeks after receiving vaccine | Y | 4 | 02/20/2021 | 03/13/2021 | 21 | PHM | 2 | 03/26/2021 | 2021VAERSSYMPTOMS | 2021VAERSVAX | 1182907 | 04/08/2021 | WI | 81.0 | 81 | M | Slight fever 1 point elevated. Muscle, body aches, fatigue, tiredness, slight headache, joint pain, sore Rt. arm, sore injection site. Side effects have subsided after approximately five (5) days. None of the side effects were considered severe! | Y | 04/03/2021 | 04/04/2021 | 1 | None | MIL | Verapamil 240mg, Omeprazole 20mg, Losartan 100mg, Pravastatin NA 40mg, Proglitazone 30mg, Levothyroxine 112mcg. Tylenol 500mg x 2, Probiotic 2 tabs | Sinusitis | Controlled type II diabetes, hypertension, | 2 | 04/08/2021 | Metformin, Lipitor | 2021VAERSSYMPTOMS | 2021VAERSVAX | 1195065 | 04/11/2021 | WI | 81.0 | 81 | M | Diagnosis - Left forehead shingles with left eye involvement Allodynia of left face and left front scalp about 4/7/21 Left eye soreness and slight redness 4/8/21 Raised red blemishes on left forehead 4/9/21 | N | 03/27/2021 | 04/07/2021 | 11 | None | PVT | Simvastatin Lisinopril/HCTZ Testosterone Gel Imipramine Aspirin 81mg Vitamin D Multivitamin Calcium | Skin cancer | Hypertension | 2 | 04/11/2021 | Y | IV Iodine - Flushing | 2021VAERSSYMPTOMS | 2021VAERSVAX | 1223510 | 04/17/2021 | WI | 81.0 | 81 | F | patient hospitalized secondary to fever, generalized weakness and myalgias and had a fall. she was hospitalized for 2 days. | Y | 2 | Y | 02/15/2021 | 02/16/2021 | 1 | Component Latest Ref Rng & Units 2/16/2021 2/16/2021 | PVT | Current Outpatient Medications Medication Sig Dispense Refill ? ALPRAZolam (Xanax) 1 MG tablet TAKE 1 TABLET BY MOUTH AT BEDTIME AS NEEDED 44 tablet 5 ? Synthroid 50 MCG tablet Take 1 tablet by mouth daily before breakfast. 90 tablet 1 ? li | none | Past Medical History: Diagnosis Date ? Blind left eye ? Depression ? DJD (degenerative joint disease) of lumbar spine ? H/O cold sores ? Hypothyroid ? Low grade mucinous neoplasm of appendix 02/27/2020 ? Mass of colon 02/2020 ? Migraine ? Personal hi | 2 | 04/17/2021 | Allergies Allergen Reactions ? Sulfa Antibiotics Rash ? Augmentin [Amoclan] Gastrointestinal Intolerance ? Dilantin [Phenytoin] Rash | 2021VAERSSYMPTOMS | 2021VAERSVAX | 1225566 | 04/18/2021 | WI | 81.0 | 81 | M | Patient had a sudden change in status one week after receiving his first Moderna Covid 19 vaccine. He had sudden onset of tachypnea RR = 40/min, apparent severe pain, greatly elevated blood pressure, with normal heart rate (on beta blocker), diaphoresis. | Y | 02/27/2021 | Y | N | 02/11/2021 | 02/18/2021 | 7 | None, due to hospice status. Received symptom management at home only. | SEN | metoprolol succinate, apixaban, clopidogrel, sertraline, tamsulosin, finasteride, famotidine, senna, ducolax | paronychia, dental caries | fronto-temporal dementia with motor neuron disease, ischemic cardiomyopathy, benign prostatic hypertrophy | 2 | 04/18/2021 | quinolone antibiotics | 2021VAERSSYMPTOMS | 2021VAERSVAX | 1237397 | 04/21/2021 | WI | 81.0 | 81 | F | CLIENT HURT HER ANKLE COMING OUT OF HER BED ON 4/10/21 AND DEVELOPED A BIG BRUISE, SWELLING, AND COOL TO TOUCH THAT DIDN'T HEAL AND REQUIRED A UREGENT CARE VISIT ON 4/21/21. SYMPTOMS HAVE STAYED THE SAME , NOT PROGRESSIVELY GETTING WORSE. CLIENT WENT TO | 04/09/2021 | 04/10/2021 | 1 | ULTRASOUND AT URGENT CARE DETERMINED NO BLOOD CLOTS IN EITHER LEG PER FAMILY REPORT | PUB | HIGH BLOOD PRESSURE, HIGH CHOLESTEROL | 2 | 04/21/2021 | Y | Y | 2021VAERSSYMPTOMS | 2021VAERSVAX | 1243059 | 04/22/2021 | WI | 81.0 | 81 | M | COVID after vaccination | Y | 02/10/2021 | 03/07/2021 | 25 | PVT | Norco 5/325mg 1.5 tabs q6hr, PRN for pain Albuterol 90mc/inh 2 puffs inhalation QID Aspirin 81 mg Daily Atorvastatin 80mg Daily Symbicort 160/4.5 2 puffs inhalation BID bumetanide 1 mg - 2 tabs qAM and 1 tab qPM Duloxetine 90 mg daily escit | Chronic Liver Disease Coronary srteriosclerosis in native artery mycardial infarction Type 2 diabetes COPD Hypertension | 2 | 04/22/2021 | Ace Inhibitors Metformin | 2021VAERSSYMPTOMS | 2021VAERSVAX | 1282539 | 05/03/2021 | WI | 81.0 | 81 | M | New onset atrial fibrillation | N | 04/12/2021 | 04/12/2021 | 0 | atrial fibrillation with rapid ventricular rhythm on EKG 5/3/2021 | PVT | albuterol, furosemide, lisinopril, metoprolol, oxybutnin, pravastatin | asthma, prostate cancer, hypertension, hyperlipidemia | 2 | 05/03/2021 | Y | None | 2021VAERSSYMPTOMS | 2021VAERSVAX | 1292574 | 05/06/2021 | WI | 81.0 | 81 | M | Client was feeling generally weak, off balance and chilled starting on 5/1. Subsequently, he developed body aches and a non productive cough. He has no sore throat, chest pain, or shortness of breath. On 5/4 the client presented to the emergency department | Y | 03/23/2021 | 05/01/2021 | 39 | UNK | 2 | 05/06/2021 | 2021VAERSSYMPTOMS | 2021VAERSVAX | 1314215 | 05/13/2021 | WI | 81.0 | 81 | F | Patient presented to the ED and was subsequently hospitalized within 6 weeks of receiving COVID vaccination. | Y | 6 | 04/06/2021 | 04/14/2021 | 8 | OTH | 2 | 05/13/2021 | Y | 2021VAERSSYMPTOMS | 2021VAERSVAX | 1323698 | 05/17/2021 | WI | 81.0 | 81 | F | Patient received the second Pfizer vaccine 4/5/2021. On 5/6 tested positive for COVID-19. She had tested positive in January as well but is had been greater than 90 days so this is considered a new illness per CDC guidelines. | Y | 04/05/2021 | 05/06/2021 | 31 | PUB | Unknown | UTI, anemia, new cancer dx | Unknown | 2 | 05/17/2021 | Unknown | 2021VAERSSYMPTOMS | 2021VAERSVAX | 1450637 | 07/06/2021 | WI | 81.0 | 81 | F | Bleeding from private area, went to walk-in clinic vitals were bad. Sent to Hospital, was kept for 7 hours. Was prescribed antibiotics. Vomiting, nauseous. | N | 03/04/2021 | 03/07/2021 | 3 | None. | PVT | Lisinopril and water pill. | None | None. | 2 | 07/06/2021 | Y | Caffeine. | 2021VAERSSYMPTOMS | 2021VAERSVAX | 1481791 | 07/18/2021 | WI | 81.0 | 81 | F | Mastitis in size of "egg" and "hot"; Lipoma; turned to brown like sun burn; Received antibiotics and she had harsh reaction to it; Itchy arm; "ed and itchy little dots" at the site of the injection which also relocated on her arm and turned to brown like " | U | 05/28/2021 | UNK | AMLODIPINE; CRESTOR; DIOVAN; HYDROCHLOROTHIAZIDE; METFORMIN; TRIAMCINOLONE; AMOXICILLIN AND CLAVUNATE POTASSIUM | Allergy to antibiotic (Allergy to Erythromycin); Allergy to antibiotic (Allergy to Cefoxitin); Drug allergy (Allergy to Viax); Drug allergy (Allergy to Valdecoxib); Drug allergy (Allergy to Codeine); Drug allergy (Allergy to Celebrex); Infection | USMODERNATX, INC.MOD20212 | 2 | 07/15/2021 | 2021VAERSSYMPTOMS | 2021VAERSVAX | 1519928 | 08/02/2021 | WI | 81.0 | 81 | M | None | Y | 07/31/2021 | N | 07/30/2021 | 07/31/2021 | 1 | None | SEN | Aspercream, Morphine and Tramadol both PRN, Aspirin 81mg, Baza Protec Cre, Ferrous Sulfate Elx-220/5ml, Ipratropium/sol Albuter, metoprol 25mg, MI-Acid SUS, Nystatin Pow 10000, Robafen Syp 100/5ml, Milk of Mag, Isosorb Mono 30mg, Omeprazole | Closed right hip fracture Acute respiratory failure | DNR Hypertension Dementia | 5701 | 2 | 08/02/2021 | None | 2021VAERSSYMPTOMS | 2021VAERSVAX | 1547829 | 08/12/2021 | WI | 81.0 | 81 | F | This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE WARMTH (It is hot to the touch), RASH (traveled down to her arm as well), VACCINATION SITE PRURITUS (It itches), VACCINATION SITE RASH (It has a rash/ about 4 | U | 01/29/2021 | 01/29/2021 | 0 | UNK | USMODERNATX, INC.MOD20210 | 2 | 08/10/2021 | 2021VAERSSYMPTOMS | 2021VAERSVAX | 1549109 | 08/12/2021 | WI | 81.0 | 81 | F | The client came to the clinic and requested her "first" Pfizer vaccine and stated she did not have a vaccine card. Her electronic record was looked up, but none was found. Her last name was entered incorrectly at check-in. The client added an "e" in the sp | Y | 08/11/2021 | 08/11/2021 | 0 | PUB | 2 | 08/12/2021 | 2021VAERSSYMPTOMS | 2021VAERSVAX | 1555283 | 08/13/2021 | WI | 81.0 | 81 | F | Arm red; Arm swollen; Arm warm; This spontaneous case was reported by a consumer and describes the occurrence of INJECTION SITE ERYTHEMA (Arm red), INJECTION SITE SWELLING (Arm swollen) and INJECTION SITE WARMTH (Arm warm) in an 81-year-old female patient | U | 01/30/2021 | 02/07/2021 | 8 | UNK | Comments: No medical history reported. | USMODERNATX, INC.MOD20210 | 2 | 08/10/2021 | 2021VAERSSYMPTOMS | 2021VAERSVAX | 1572456 | 08/16/2021 | WI | 81 | F | Diarrhea; Extreme Tiredness; This spontaneous case was reported by a consumer and describes the occurrence of DIARRHOEA (Diarrhea) and FATIGUE (Extreme Tiredness) in an 81-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. | N | 01/20/2021 | 01/20/2021 | 0 | UNK | Medical History/Concurrent Conditions: No adverse event (No medical history provided) | USMODERNATX, INC.MOD20210 | 2 | 08/12/2021 | 2021VAERSSYMPTOMS | 2021VAERSVAX | 1580707 | 08/18/2021 | WI | 81.0 | 81 | F | DRY COUGH; This spontaneous case was reported by a consumer and describes the occurrence of COUGH (DRY COUGH) in an 81-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 007M20A) for COVID-19 vaccination. The patient's | Y | 01/27/2021 | 01/30/2021 | 3 | UNK | Medical History/Concurrent Conditions: Arthritis; Blood pressure | USMODERNATX, INC.MOD20210 | 2 | 08/13/2021 | 2021VAERSSYMPTOMS | 2021VAERSVAX | 1592347 | 08/20/2021 | WI | 81.0 | 81 | F | Symptoms started out like an allergy within a week. Extreme tired, headache, congestion and overall feeling unwell. Made a video appt. with Dr. describing sinus infection symptoms. Took antibiotic for a week, but symptoms worsened. Three weeks after the | Y | Y | 20 | Y | N | 02/06/2021 | 02/15/2021 | 9 | EKG Stress Test | PVT | Blood Pressure Cholesterol | COPD High Blood Pressure High Cholesterol | 2 | 08/20/2021 | Y | Y | Penicillin | 2021VAERSSYMPTOMS | 2021VAERSVAX | 1600389 | 08/21/2021 | WI | 81.0 | 81 | M | nausea; This spontaneous case was reported by a consumer and describes the occurrence of NAUSEA (nausea) in an 81-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 001B21A and 012M20A) for COVID-19 vaccination. The pat | U | 02/13/2021 | 03/13/2021 | 28 | UNK | Medical History/Concurrent Conditions: No adverse event | USMODERNATX, INC.MOD20210 | 2 | 08/17/2021 | 2021VAERSSYMPTOMS | 2021VAERSVAX | 1612364 | 08/22/2021 | WI | 81.0 | 81 | M | Missed 2nd shot and asking for 2nd shot which will be passed 42 days; This spontaneous case was reported by a health care professional and describes the occurrence of PRODUCT DOSE OMISSION IN ERROR (Missed 2nd shot and asking for 2nd shot which will be pas | Y | 03/11/2021 | UNK | Medical History/Concurrent Conditions: No adverse reaction | USMODERNATX, INC.MOD20210 | 2 | 08/17/2021 | 2021VAERSSYMPTOMS | 2021VAERSVAX | 1626846 | 08/24/2021 | WI | 81.0 | 81 | F | Left Arm Had A Lump; Left Arm Was Very Itchy; Left Arm Was Red; Mastitis; Deathly Sick; Sleeping All Night; Not Eating Or Drinking A Lot; Very Dizzy; This spontaneous case was reported by a consumer and describes the occurrence of MASTITIS (Mastitis), ILLN | N | 05/28/2021 | 06/04/2021 | 7 | UNK | AMOXCLAV [AMOXICILLIN;CLAVULANIC ACID]; FISH OIL; TYLENOL; AMLODIPINE; CRESTOR; DIOVAN; HYDROCHLOROTHIAZIDE; METFORMIN; TRIAMCINOLONE | Hypertension; Lipoma | Medical History/Concurrent Conditions: Mastitis (breast infections infection flared up 4-jun-2021) | USMODERNATX, INC.MOD20212 | 2 | 08/16/2021 | 2021VAERSSYMPTOMS | 2021VAERSVAX | 1655975 | 08/30/2021 | WI | 81.0 | 81 | M | Pain in left shoulder and arm terrebile pain went to clinic next day.Am on steroids but still can't raise left arm completly | N | 08/26/2021 | 08/26/2021 | 0 | On Presedone | PVT | Metoprol, Atrovostin, Amlodopine, Losartin, Tamsulson, Finistrade, Omperozale, Isosorbide | None | good had a by pass 7 years ago but blood pressure and cholosterel is good | 2 | 08/30/2021 | Penicellin Diclofenec | 2021VAERSSYMPTOMS | 2021VAERSVAX | 1662856 | 09/01/2021 | WI | 81.0 | 81 | M | In August, I started feeling lethargic. I had lose of energy. I was confused at time. My wife noticed it. I went to the doctor. They did a COVID-19 test, which came out positive. They did blood work. | Y | 02/24/2021 | 08/03/2021 | 160 | COVID-19 test blood work | PVT | vsafe | 2 | 09/01/2021 | Y | bees | 2021VAERSSYMPTOMS | 2021VAERSVAX | 1700147 | 09/15/2021 | WI | 81.0 | 81 | F | Presented on the evening of 8/28/2021 following a fall with bilateral leg pain as well as weakness and deconditioning. She was also noted to be bradycardic with heart rates in the 50s. Unfortunately her COVID-19 PCR test on 8/31/21 came back positive. T | Y | 15 | Y | 04/09/2021 | 08/31/2021 | 144 | PVT | COPD, chronic respiratory failure on 3 L at night, paroxysmal atrial flutter, CAD | 2 | 09/15/2021 | 2021VAERSSYMPTOMS | 2021VAERSVAX | 1715325 | 09/20/2021 | WI | 81.0 | 81 | F | Moderna COVID-19 Vaccine EUA - On Sept.15, I was given the injection, and felt nothing! No needle pick, nothing. Felt fine the rest of the night. Got up twice during the night to use the bathroom and get a drink of water, as I read to stay HYDRATED! Awo | Y | 09/15/2021 | 09/16/2021 | 1 | None | PVT | I took 300mg Imatinib Mesylate that morning. At noon I took 600 mg Caltrate + D3, one Perservision tablet, and 1 - 1200mg fish oil with 360 mg Omega-3. | Just seasonal allergies and I took Zyrtek, when needed for that, but rarely. I didn't take any the day of my Moderna vaccination. | I have leukemia - Chronic Myeloid Leukemia (CML) | 2nd shot of Moderna on 3/10/2021 | 2 | 09/20/2021 | None | 2021VAERSSYMPTOMS | 2021VAERSVAX | 1726641 | 09/23/2021 | WI | 81.0 | 81 | M | Patient contracted COVID after being fully vaccinated | Y | 04/09/2021 | 07/21/2021 | 103 | PVT | acetaminophen, albuterol, budesonide, Calcium-vitamin D, diltiazem, formoterol, furosemide, guaifenesin, magnesium oxide, menthol topical, metoprolol, multivitamin, Fish oil, ondansetron, miralax, potassium chloride, prednisone, rivaroxaban | coronary atherosclerosis, hypertension, hyperlipidemia, asthma, atrial fibrillation, heart failure, emphysema | 2 | 09/23/2021 | No known allergies | 2021VAERSSYMPTOMS | 2021VAERSVAX | 1727473 | 09/23/2021 | WI | 81.0 | 81 | M | Patient recieved first COVID vaccine dose 2/9 and second dose 3/9/2021. COVID positive: 9/20/2021 HOSPITAL COURSE: Patient admitted under observational status for generalized weakness, lethargy, increased confusion and inability to be cared for at home | Y | 1 | 02/09/2021 | 09/20/2021 | 223 | UNK | 2 | 09/23/2021 | 2021VAERSSYMPTOMS | 2021VAERSVAX | 1740861 | 09/28/2021 | WI | 81.0 | 81 | F | Extreme knee joint pain that began a few hours after her Covid vaccine in January and again in February with her second injection. Patient states that she started having the severe leg pain and cramps a few hours after her first and then her second Covid v | Y | N | 01/25/2021 | 02/15/2021 | 21 | None | PVT | She does not take any daily medications they are all as needed. | hyperlipidemia | 2 | 09/28/2021 | Statins | 2021VAERSSYMPTOMS | 2021VAERSVAX | 1753305 | 10/01/2021 | WI | 81.0 | 81 | F | Patient states that after receiving the 3rd dose Booster Pfizer 09/29/2021, started experiencing symptoms 10/01/2021 of rash across the back and abdominal area. Primary communications 10/01/2021 suggested self-treating with Benadryl. No other symptoms note | N | 09/29/2021 | 10/01/2021 | 2 | N/A. | PHM | N/A | N/A | N/A | 2 | 10/01/2021 | Y | N/A | 2021VAERSSYMPTOMS | 2021VAERSVAX | 1788189 | 10/15/2021 | WI | 81.0 | 81 | M | Patient scheduled for 3 dose of Moderna vaccine which was given by nursing staff. Patient did not present proof of first 2 doses. After administration of Moderna vaccine, it was discovered that first 2 doses were Pfizer | U | 10/15/2021 | 10/15/2021 | 0 | PVT | albuterol inhaler, arformoterol, benadryl, gabapentin, glipizide XL, duoneb, metformin, triamcinolone cream | none | diabetes mellitus, neuropathy, COPD, hyperlipidemia, cognitive impairment, obesity, Stage 3a chronic kidney disease | 2 | 10/15/2021 | aspirin | 2021VAERSSYMPTOMS | 2021VAERSVAX | 1815225 | 10/25/2021 | WI | 81.0 | 81 | F | Patient contracted COVID after being fully vaccinated Shortness of breath and cough | 02/26/2021 | 10/25/2021 | 241 | 10/25/2021: BMP, CCBC, Blood gas venous, BNP, Troponin Chest Xray | PVT | acetaminophen 500mg q6hr prn for pain albuterol q4hr prn for cough ascorbic acid 500mg daily atorvastatin 10mg HS buspirone 15mg TID calcium carbonate 600mg daily cholecalciferol 1000IU daily Codeine-guaifenesin 5mL q6hr prn for cough and c | None documented | Hyperreactive airway disease, hypertension disorder, hyperlipidemia, peripheral neuropathy, type II diabetes, diverticular disease of large intestine, centriacinar emphysema, chronic diastolic heart failure, iron deficiency anemia, longstanding persistent | 2 | 10/25/2021 | Y | ACE inhibitors - Cough Hyzaar - Hypokalemia | 2021VAERSSYMPTOMS | 2021VAERSVAX | 1817305 | 10/26/2021 | WI | 81.0 | 81 | F | Patient got first dose of the Moderna vaccine and second dose of the Pfizer vaccine; This spontaneous case was reported by a consumer and describes the occurrence of INTERCHANGE OF VACCINE PRODUCTS (Patient got first dose of the Moderna vaccine and second | Y | 02/24/2021 | 03/17/2021 | 21 | UNK | VITAMIN D3; VIT C | Acid reflux (esophageal); Blood pressure high; MS | USMODERNATX, INC.MOD20213 | 2 | 10/25/2021 | 2021VAERSSYMPTOMS | 2021VAERSVAX | 1828710 | 10/29/2021 | WI | 81.0 | 81 | M | Patient hospitalized. On 10/27, patient was diagnosed with COVID-19 at his nursing home where he has been residing since discharge from the hospital in September after being treated for pneumonia with sepsis. Patient was vaccinated with Moderna on 2/9/2 | Y | N | 03/16/2021 | 10/28/2021 | 226 | Vital stable, afebrile, initially on room air though eventually requiring 2 L Relevant Labs: Electrolytes within normal limits, CRP 5.9, D-dimer 3763, lactate 1.2, procalcitonin 0.51 CT scan with large, cumulative right pleural effusion, associated compre | PVT | unknown | Unknown | ESRD on dialysis, anemia associated with CKD, hypertension, multiple myeloma, osteoporosis with back pain due to spinal compression fractures, OSA on CPAP | 2 | 10/29/2021 | Hydralazine Sulfa (sulfonamide Antibiotics) | 2021VAERSSYMPTOMS | 2021VAERSVAX | 1837010 | 11/02/2021 | WI | 81.0 | 81 | M | Received Moderna vaccines on 2/17/21, 3/17/21. Tested positive for COVID 19 by PCR on 10/29/21. admitted to Hospital on 10/29/21 w/ SOB, hypoxia, pneumonia. Underlying obesity BMI 54. Started on Remdesivir, dexamethasone. Currently on ventilator | Y | 03/17/2021 | 10/29/2021 | 226 | UNK | 2 | 11/02/2021 | 2021VAERSSYMPTOMS | 2021VAERSVAX | 1842820 | 11/04/2021 | WI | 81.0 | 81 | M | Patient is a 82 y.o. left-handed male with hx of Afib on Eliquis, DM, HLD, HTN admitted after being found to be COVID positive and recent symptoms of diarrhea, malaise. Stroke activated due to aphasia, dysarthria of onset approximately 1415; patient was re | Y | 1 | 02/13/2021 | 11/01/2021 | 261 | UNK | finasteride, omeprazole, omeprazole, sertraline, tamsulosin | 2 | 11/04/2021 | Zomepirac, Azithromycin, Metformin | 2021VAERSSYMPTOMS | 2021VAERSVAX | 1860764 | 11/11/2021 | WI | 81.0 | 81 | F | Fatigue and gastro-intestinal (diarrhea) | N | 11/09/2021 | 11/10/2021 | 1 | N.A. | PHM | vitamins | None | None | 2 | 11/11/2021 | none | 2021VAERSSYMPTOMS | 2021VAERSVAX |