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|History of Changes from the VAERS Wayback Machine|
|Vaccination / Manufacturer||Lot / Dose||Site / Route|
|COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA||300042698 / 1||- / OT|
Administered by: Unknown Purchased by: ??
Life Threatening? No
Birth Defect? No
Permanent Disability? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Preexisting Conditions: Medical History/Concurrent Conditions: No adverse event (No adverse event history.)
Diagnostic Lab Data:
CDC 'Split Type': NLMODERNATX, INC.MOD20210
Write-up: Pyrexia; A regulatory authority report was received from a health care professional concerning a 90 years old female patient who received Moderna''s COVID-19 vaccine (mRNA-1273) and experienced pyrexia. The patient''s medical history was not provided. No relevant concomitant medications were reported. On 02 Feb 2021 prior to the onset of the events, the patient received their first of two planned doses of mRNA-1273 (Batch/Lot number: 300042698) for prophylaxis of COVID-19 infection. On 05 Feb 2021, pyrexia has started, which was confirmed by conducting pyrexia lab test with test result as: 38 tot 40.5 degrees Celsius. No treatment information was provided. Action taken with mRNA-1273 in response to the events was not applicable. The outcome of the event, pyrexia, was fatal.; Reporter''s Comments: Very limited information regarding the fatal event of pyrexia in this elderly patient has been provided at this time. Based on the limited information available, it is difficult to assess a cause and effect relationship.; Reported Cause(s) of Death: unknown cause of death
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