|
VAERS ID: |
963213 (history) |
Form: |
Version 2.0 |
Age: |
30.0 |
Sex: |
Male |
Location: |
California |
Vaccinated: |
2021-01-18 |
Onset: |
2021-01-21 |
Days after vaccination: |
3 |
Submitted: |
0000-00-00 |
Entered: |
2021-01-21 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA |
011J20A / 1 |
LA / IM |
Administered by: Public Purchased by: ? Symptoms: Acute myocardial infarction, Catheterisation cardiac, Chest pain, Electrocardiogram ST segment elevation, Myocarditis, Troponin increased SMQs:, Myocardial infarction (narrow), Embolic and thrombotic events, arterial (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad), Noninfectious myocarditis/pericarditis (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? Yes, ? days Extended hospital stay? No Previous Vaccinations: Other Medications: Daily Multivitamin Current Illness: No Preexisting Conditions: None Allergies: None Diagnostic Lab Data: 1/21/2021: Troponin 4.8 at 10:00. EKG showed inferior and lateral ST elevation CDC Split Type: Write-up: Patient had 4 hours of chest pain 3 days after vaccine. EKG showed STEMI. Troponin elevated at 4.8. Patient sent for cardiac catheterization and results pending. At this time suspect myocarditis, but STEMI not yet excluded |
|
VAERS ID: |
965715 (history) |
Form: |
Version 2.0 |
Age: |
57.0 |
Sex: |
Female |
Location: |
Florida |
Vaccinated: |
2021-01-08 |
Onset: |
2021-01-08 |
Days after vaccination: |
0 |
Submitted: |
0000-00-00 |
Entered: |
2021-01-22 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA |
039K20A / 1 |
LA / IM |
Administered by: Private Purchased by: ? Symptoms: Asthenia, Blood test, Catheterisation cardiac, Chest pain, Echocardiogram, Electrocardiogram, Magnetic resonance imaging, Myocarditis, Viral cardiomyopathy SMQs:, Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad), Noninfectious myocarditis/pericarditis (narrow) Life Threatening? Yes Birth Defect? No Died? No Permanent Disability? No Recovered? No Office Visit? Yes ER Visit? No ER or Doctor Visit? Yes Hospitalized? Yes, 3 days Extended hospital stay? No Previous Vaccinations: Other Medications: None Current Illness: None Preexisting Conditions: Breast Cancer 2010 Allergies: None Diagnostic Lab Data: Blood work, EKG, Echocardiogram, MRI, cardiac catheterization CDC Split Type: Write-up: viral cardiomyopathy, myopericarditis, weakness, chest pains |
|
VAERS ID: |
966794 (history) |
Form: |
Version 2.0 |
Age: |
55.0 |
Sex: |
Male |
Location: |
California |
Vaccinated: |
2021-01-08 |
Onset: |
2021-01-19 |
Days after vaccination: |
11 |
Submitted: |
0000-00-00 |
Entered: |
2021-01-22 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA |
025J 20-2A / 1 |
RA / IM |
Administered by: Private Purchased by: ? Symptoms: Back pain, Chest pain, Computerised tomogram normal, Echocardiogram normal, Electrocardiogram normal, Impaired work ability, Laboratory test normal, Magnetic resonance imaging normal, Pain, Pericarditis, Troponin normal SMQs:, Systemic lupus erythematosus (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Chronic kidney disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad), Noninfectious myocarditis/pericarditis (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: Cellulitis in injected arm. Age 50y Pneumonia vaccine given around 2016 Other Medications: Wixela, Sildenafil Current Illness: None Preexisting Conditions: Asthma, hypertension Allergies: None Diagnostic Lab Data: 1/19/21: CTA w contrast, no aortic dissection Blood work x 2, negative Troponin and inflammatory markers Echo, no pericardial effusion MRI w contrast, no pericardial effusion and normal pericardial thickness EKG, diffuse ST segment elevation more pronounced than baseline ECG done in 2018 which showed early repolarization CDC Split Type: Write-up: Severe stabbing chest and back pain radiating to the left axilla. Diagnosed with atypical pericarditis with diffuse ST elevation on EKG but no effusion or pericardial thickening on echo/MRI. Treated with ongoing Colchicine and complete resolution of pain. Spent the night under ER observation. Missed 4 days of work. |
|
VAERS ID: |
968687 (history) |
Form: |
Version 2.0 |
Age: |
23.0 |
Sex: |
Male |
Location: |
Unknown |
Vaccinated: |
2021-01-20 |
Onset: |
2021-01-21 |
Days after vaccination: |
1 |
Submitted: |
0000-00-00 |
Entered: |
2021-01-24 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA |
- / 2 |
- / IM |
Administered by: Private Purchased by: ? Symptoms: Chest pain, Echocardiogram normal, Electrocardiogram PR segment depression, Electrocardiogram ST segment elevation, Myocarditis, Pericarditis, Troponin increased SMQs:, Systemic lupus erythematosus (broad), Myocardial infarction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Other ischaemic heart disease (broad), Chronic kidney disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad), Noninfectious myocarditis/pericarditis (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? Yes, 2 days Extended hospital stay? No Previous Vaccinations: Other Medications: Aripiprazole Buspirone Quetiapine Sertraline Current Illness: No Preexisting Conditions: No Allergies: Lorazepam (hives and hallucinations) Diagnostic Lab Data: Found to have elevated troponin (peaked at 4.0 ng/mL). ECG showed diffuse PR segment depressions and ST segment elevations consistent with pericarditis. Transthoracic echocardiogram was normal. CDC Split Type: Write-up: Acute myopericarditis Chest pain developed 24 hours after vaccine administration. Presented to emergency department 48 hours after vaccine administration. Symptoms resolved after an additional 24 hours (72 hrs after vaccine) with administration of ibuprofen three times daily. |
|
VAERS ID: |
969618 (history) |
Form: |
Version 2.0 |
Age: |
|
Sex: |
Female |
Location: |
Illinois |
Vaccinated: |
2020-12-30 |
Onset: |
2021-01-04 |
Days after vaccination: |
5 |
Submitted: |
0000-00-00 |
Entered: |
2021-01-25 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA |
0011JZ0A / 1 |
- / OT |
Administered by: Unknown Purchased by: ? Symptoms: Chest pain, Pericarditis SMQs:, Systemic lupus erythematosus (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Chronic kidney disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad), Noninfectious myocarditis/pericarditis (narrow) 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: Medical History/Concurrent Conditions: No adverse event (No reported medical history) Allergies: Diagnostic Lab Data: CDC Split Type: USMODERNATX, INC.MOD20210 Write-up: Pericarditis; Severe chest pain; A spontaneous report was received from a 56 year-old, female consumer, who was also the patient, who received Moderna''s COVID-19 vaccine (mRNA-1273) and experienced pericarditis and severe chest pain. The patient''s medical history was not provided. Concomitant product use was not provided by the reporter. On 30 Dec 2020, approximately five days prior to the onset of symptoms, the patient received their first of two planned doses of mRNA-1273 (Lot number: 0011JZ0A) intramuscularly for prophylaxis of COVID-19 infection. On 04 Jan 2021, the patient went to the emergency room due to severe chest pain. On 05 Jan 2021, the patient went to see the cardiologist and was diagnosed with pericarditis. Treatment information was not provided. Action taken with mRNA-1273 in response to the events was not provided. The outcome of the events, pericarditis and severe chest pain, was unknown.; Reporter''s Comments: This case concerns a 56 year old, female patient. The patient''s medical history was not provided. The patient experienced a serious, unexpected event of pericarditis and severe chest pain. The event of severe chest pain occurred 5 days and the event of pericarditis occurred after 6 days after first dose of mRNA-1273 (Lot number: 0011JZ0A). Very limited information regarding this event has been provided at this time. Based on temporal association between the use of the mRNA-1273 and the start date of the event, a causal relationship cannot be excluded. |
|
VAERS ID: |
977242 (history) |
Form: |
Version 2.0 |
Age: |
36.0 |
Sex: |
Male |
Location: |
Ohio |
Vaccinated: |
2021-01-22 |
Onset: |
2021-01-26 |
Days after vaccination: |
4 |
Submitted: |
0000-00-00 |
Entered: |
2021-01-27 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA |
028L20A / 2 |
LA / IM |
Administered by: Private Purchased by: ? Symptoms: Chest discomfort, Electrocardiogram ST segment elevation, Hypoaesthesia, Magnetic resonance imaging heart, Myocarditis, Pain in extremity, Troponin increased SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Myocardial infarction (narrow), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad), Sexual dysfunction (broad), Noninfectious myocarditis/pericarditis (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? Yes, ? days Extended hospital stay? No Previous Vaccinations: Other Medications: None Current Illness: None Preexisting Conditions: None Allergies: None Diagnostic Lab Data: Patient''s EKG showed diffuse ST elevations, c/w diagnosis Troponin elevated and peaked at 3.4 Cardiac MRI pending CDC Split Type: Write-up: Patient developed myopericarditis requiring hospitalization four days after receiving second dose of moderna vaccine. He developed left arm pain and numbness as well as substernal chest pressure. He was admitted. |
|
VAERS ID: |
980243 (history) |
Form: |
Version 2.0 |
Age: |
39.0 |
Sex: |
Female |
Location: |
Unknown |
Vaccinated: |
2020-12-30 |
Onset: |
2021-01-13 |
Days after vaccination: |
14 |
Submitted: |
0000-00-00 |
Entered: |
2021-01-27 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA |
025J20-2A / 1 |
LA / IM |
Administered by: Other Purchased by: ? Symptoms: Pericarditis, Pleural effusion, Pleuritic pain SMQs:, Systemic lupus erythematosus (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Chronic kidney disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Immune-mediated/autoimmune disorders (broad), Noninfectious myocarditis/pericarditis (narrow) Life Threatening? No Birth Defect? No Died? No Permanent Disability? No Recovered? No Office Visit? Yes ER Visit? No ER or Doctor Visit? Yes Hospitalized? Yes, ? days Extended hospital stay? No Previous Vaccinations: Other Medications: Levothyroxine Current Illness: Viral illness dec 15 , 2020 Preexisting Conditions: Hypothyroidism Allergies: Garbanzo beans, Nsaids Diagnostic Lab Data: CDC Split Type: Write-up: Acute pericarditis, left pleural effusion.severe typical pericarditis and pleuritic Chest pain started 1/13 , got worse , went to Er on 1/15/2021 , was admitted to cardiology service and discharged 1/17/2021 and now on colchicine since admission. |
|
VAERS ID: |
983362 (history) |
Form: |
Version 2.0 |
Age: |
25.0 |
Sex: |
Female |
Location: |
California |
Vaccinated: |
2021-01-08 |
Onset: |
2021-01-13 |
Days after vaccination: |
5 |
Submitted: |
0000-00-00 |
Entered: |
2021-01-28 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA |
025220A / 1 |
UN / IM |
Administered by: Private Purchased by: ? Symptoms: Blood creatine phosphokinase MB increased, Chest pain, Dyspnoea, Electrocardiogram ST segment depression, Myalgia, Myocarditis, Pyrexia, Troponin increased SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Myocardial infarction (narrow), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Other ischaemic heart disease (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypokalaemia (broad), Immune-mediated/autoimmune disorders (broad), Noninfectious myocarditis/pericarditis (narrow) Life Threatening? Yes Birth Defect? No Died? No Permanent Disability? No Recovered? Yes Office Visit? No ER Visit? No ER or Doctor Visit? No Hospitalized? Yes, 8 days Extended hospital stay? No Previous Vaccinations: Other Medications: Tylenol Current Illness: None Preexisting Conditions: None Allergies: None Diagnostic Lab Data: Troponin: 3.7 CKMB:$g27 EKG findings with ST segment depression in III, aVF, V4, V5 CDC Split Type: Write-up: 7 Days after receiving the vaccine, patient developed generalized myalgia, fever, shortness of breath, and chest pain. Patient admitted to our hospital on 21JAN and diagnosed with myocarditis. Difficult to elucidate whether the myocarditis was secondary to Moderna vaccination or other viral etiologies. |
|
VAERS ID: |
989822 (history) |
Form: |
Version 2.0 |
Age: |
52.0 |
Sex: |
Male |
Location: |
Texas |
Vaccinated: |
2021-01-26 |
Onset: |
2021-01-29 |
Days after vaccination: |
3 |
Submitted: |
0000-00-00 |
Entered: |
2021-01-31 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA |
- / UNK |
- / IM |
Administered by: Private Purchased by: ? Symptoms: C-reactive protein increased, Catheterisation cardiac normal, Chest pain, Echocardiogram normal, Electrocardiogram normal, Fatigue, Headache, Left ventricular dysfunction, Magnetic resonance imaging abnormal, Magnetic resonance imaging heart, Malaise, Myalgia, Myocarditis, Pyrexia, Red blood cell sedimentation rate increased, SARS-CoV-2 test negative, Troponin T increased, Troponin increased SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Neuroleptic malignant syndrome (broad), Myocardial infarction (narrow), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (broad), Noninfectious myocarditis/pericarditis (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? Yes, 4 days Extended hospital stay? No Previous Vaccinations: Other Medications: Lisinopril, atorvastatin, ezetimibe, Current Illness: None Preexisting Conditions: none Allergies: No Diagnostic Lab Data: hs-cTnI peaked at 6700 CRP 19, ESR 25, normal cath, ECG Markedly abnormal cardiac MRI with clear evidence myocarditis Negative COVID PCR x 2 CDC Split Type: Write-up: The patient had a very severe side effect profile from the second dose of vaccine: "worst I''ve ever felt" with myalgia, headache, fever and fatigue. This subsided and then on day 3 he developed severe substernal chest pain and came to ER where his hs-cTnI was $g 2000 ng/L and peaked at 6700 ng/L. His ECG, echo and cardiac cath were normal but MRI showed evidence of myocarditis with mild left ventricular dysfunction. He is doing well clinically and we are managing expectantly. This appears to be immune mediated myocarditis from the Moderna vaccine |
|
VAERS ID: |
990198 (history) |
Form: |
Version 2.0 |
Age: |
33.0 |
Sex: |
Female |
Location: |
Unknown |
Vaccinated: |
2021-01-09 |
Onset: |
2021-01-14 |
Days after vaccination: |
5 |
Submitted: |
0000-00-00 |
Entered: |
2021-02-01 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA |
025AL20A / 1 |
RA / IM |
Administered by: Military Purchased by: ? Symptoms: Atrioventricular block first degree, Bundle branch block right, C-reactive protein, Chest pain, Dyspnoea, Electrocardiogram abnormal, Fatigue, Full blood count, Lipids, Metabolic function test, Pericarditis, Red blood cell sedimentation rate SMQs:, Anaphylactic reaction (broad), Systemic lupus erythematosus (broad), Arrhythmia related investigations, signs and symptoms (broad), Conduction defects (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Chronic kidney disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad), Noninfectious myocarditis/pericarditis (narrow) 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: Nexplanon, prenatal vitamin, Lunesta PRN Current Illness: None Preexisting Conditions: None Allergies: NKA Diagnostic Lab Data: EKG- 14Jan- 1st degree AV block with RBBB EKG- 19Jan- 1st degree AV block- LIPID Panel, BMP 27Jan- Echocardiogram- Mild Pericarditis- ESR, C-reactive, CBC CDC Split Type: Write-up: During cardiovascular exercise experienced SOB, Dyspnea, Chest pain, during and for 1-2hrs post cardio exercise. this continued for 2-3 days. with fatigue, sob,. Pt. had EKG performed which showed 1st degree AV block w RBBB. Pt. was then referred to cardiology where she was seen and diagnosed on 27Jan with pericarditis. Pt has since started NSAID therapy with mild symptoms persisting. Pt. will have Cardiology follow-up at 4weeks time. |
|