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|History of Changes from the VAERS Wayback Machine|
|Vaccination / Manufacturer||Lot / Dose||Site / Route|
|COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA||300042721 / 1||- / OT|
Administered by: Unknown Purchased by: ??
Symptoms: Asthenia, Dizziness, Feeling hot, Myalgia, Respiratory failure, COVID-19
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
Hospitalized? Yes, days:
Write-up: Respiratory failure; Dizziness; Feeling hot; Weakness generalized; Muscle pain; COVID-19; This regulatory authority case was reported by a non-health professional and describes the occurrence of RESPIRATORY FAILURE (Respiratory failure) and COVID-19 (COVID-19) in a 74-year-old male patient who received mRNA-1273 (COVID 19 Vaccine Moderna) (batch no. 300042721) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. Concurrent medical conditions included Spinal disorder (Degeneration of the spine). On 20-Feb-2021, the patient received first dose of mRNA-1273 (COVID 19 Vaccine Moderna) (Intramuscular) 1 dosage form. On 03-Mar-2021, the patient experienced DIZZINESS (Dizziness), FEELING HOT (Feeling hot), ASTHENIA (Weakness generalized) and MYALGIA (Muscle pain). On 05-Mar-2021, the patient experienced RESPIRATORY FAILURE (Respiratory failure) (seriousness criterion death) and COVID-19 (COVID-19) (seriousness criterion death). The patient died on 05-Mar-2021. The reported cause of death was Respiratory failure and covid-19, virus identified. It is unknown if an autopsy was performed. At the time of death, DIZZINESS (Dizziness), FEELING HOT (Feeling hot), ASTHENIA (Weakness generalized) and MYALGIA (Muscle pain) outcome was unknown. Concomitant product use was not provided. Treatment information was not provided. The reporter''s contact information was not provided. Reporter did not allow further contact; Reported Cause(s) of Death: Respiratory failure; COVID-19, virus identified
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