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This is VAERS ID 1249630

History of Changes from the VAERS Wayback Machine

First Appeared on 4/30/2021

VAERS ID: 1249630
VAERS Form:2
Age:63.0
Sex:Female
Location:Kansas
Vaccinated:0000-00-00
Onset:2021-04-19
Submitted:0000-00-00
Entered:2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / OT

Administered by: Unknown      Purchased by: ??
Symptoms: Haematochezia, Haemorrhoids, Rectal haemorrhage

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Rectal bleeding (10 years ago)
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': USMODERNATX, INC.MOD20210

Write-up: Hemorrhoid; Minor bleeding issues/ hemorrhoid; Clot of blood in stool; This spontaneous case was reported by a consumer and describes the occurrence of RECTAL HAEMORRHAGE (Minor bleeding issues/ hemorrhoid) and HAEMATOCHEZIA (Clot of blood in stool) in a 63-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. The patient''s past medical history included Rectal bleeding (10 years ago). On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 19-Apr-2021, the patient experienced RECTAL HAEMORRHAGE (Minor bleeding issues/ hemorrhoid) (seriousness criterion medically significant) and HAEMATOCHEZIA (Clot of blood in stool) (seriousness criterion medically significant). On an unknown date, the patient experienced HAEMORRHOIDS (Hemorrhoid). At the time of the report, RECTAL HAEMORRHAGE (Minor bleeding issues/ hemorrhoid), HAEMATOCHEZIA (Clot of blood in stool) and HAEMORRHOIDS (Hemorrhoid) had not resolved. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Treatment information was not provided. On unknown date, the evening after receiving the Moderna COVID-19 vaccine, the patient reported seeing a blood clot in the toilet. The patient stated it looked like hemorrhoids. The patient denied seeking medical care. The patient stated the bleeding is minor but at the time of this report, ongoing. The patient stated having similar minor bleeding approximately 10 years ago. This case concerns a 63-year-old female with PMH of rectal bleeding had serious unexpected events of Rectal hemorrhage, hematochezia and non serious unexpected hemorrhoids. Event onset with unknown latency. after first dose mRNA-1273. Events ongoing. Based on current available information and temporal association between the use of the product and the start date of the event, a causal relationship cannot be excluded.; Sender''s Comments: This case concerns a 63-year-old female with PMH of rectal bleeding had serious unexpected events of Rectal hemorrhage, hematochezia and nonserious unexpected hemorrhoids. Event onset with unknown latency. after first dose mRNA-1273. Events ongoing. Based on current available information and temporal association between the use of the product and the start date of the event, a causal relationship cannot be excluded.


Changed on 5/7/2021

VAERS ID: 1249630 Before After
VAERS Form:2
Age:63.0
Sex:Female
Location:Kansas
Vaccinated:0000-00-00
Onset:2021-04-19
Submitted:0000-00-00
Entered:2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / OT

Administered by: Unknown      Purchased by: ??
Symptoms: Haematochezia, Haemorrhoids, Rectal haemorrhage

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Rectal bleeding (10 years ago)
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': USMODERNATX, INC.MOD20210

Write-up: Hemorrhoid; Minor bleeding issues/ hemorrhoid; Clot of blood in stool; This spontaneous case was reported by a consumer and describes the occurrence of RECTAL HAEMORRHAGE (Minor bleeding issues/ hemorrhoid) and HAEMATOCHEZIA (Clot of blood in stool) in a 63-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. The patient''s past medical history included Rectal bleeding (10 years ago). On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 19-Apr-2021, the patient experienced RECTAL HAEMORRHAGE (Minor bleeding issues/ hemorrhoid) (seriousness criterion medically significant) and HAEMATOCHEZIA (Clot of blood in stool) (seriousness criterion medically significant). On an unknown date, the patient experienced HAEMORRHOIDS (Hemorrhoid). At the time of the report, RECTAL HAEMORRHAGE (Minor bleeding issues/ hemorrhoid), HAEMATOCHEZIA (Clot of blood in stool) and HAEMORRHOIDS (Hemorrhoid) had not resolved. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Treatment information was not provided. On unknown date, the evening after receiving the Moderna COVID-19 vaccine, the patient reported seeing a blood clot in the toilet. The patient stated it looked like hemorrhoids. The patient denied seeking medical care. The patient stated the bleeding is minor but at the time of this report, ongoing. The patient stated having similar minor bleeding approximately 10 years ago. This case concerns a 63-year-old female with PMH of rectal bleeding had serious unexpected events of Rectal hemorrhage, hematochezia and non serious unexpected hemorrhoids. Event onset with unknown latency. after first dose mRNA-1273. Events ongoing. Based on current available information and temporal association between the use of the product and the start date of the event, a causal relationship cannot be excluded.; Sender''s Comments: This case concerns a 63-year-old female with PMH of rectal bleeding had serious unexpected events of Rectal hemorrhage, hematochezia and nonserious unexpected hemorrhoids. Event onset with unknown latency. after first dose mRNA-1273. Events ongoing. Based on current available information and temporal association between the use of the product and the start date of the event, a causal relationship cannot be excluded.


Changed on 5/14/2021

VAERS ID: 1249630 Before After
VAERS Form:2
Age:63.0
Sex:Female
Location:Kansas
Vaccinated:0000-00-00
Onset:2021-04-19
Submitted:0000-00-00
Entered:2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / OT

Administered by: Unknown      Purchased by: ??
Symptoms: Haematochezia, Haemorrhoids, Rectal haemorrhage

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Rectal bleeding (10 years ago)
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': USMODERNATX, INC.MOD20210

Write-up: Hemorrhoid; Minor bleeding issues/ hemorrhoid; Clot of blood in stool; This spontaneous case was reported by a consumer and describes the occurrence of RECTAL HAEMORRHAGE (Minor bleeding issues/ hemorrhoid) and HAEMATOCHEZIA (Clot of blood in stool) in a 63-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. The patient''s past medical history included Rectal bleeding (10 years ago). On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 19-Apr-2021, the patient experienced RECTAL HAEMORRHAGE (Minor bleeding issues/ hemorrhoid) (seriousness criterion medically significant) and HAEMATOCHEZIA (Clot of blood in stool) (seriousness criterion medically significant). On an unknown date, the patient experienced HAEMORRHOIDS (Hemorrhoid). At the time of the report, RECTAL HAEMORRHAGE (Minor bleeding issues/ hemorrhoid), HAEMATOCHEZIA (Clot of blood in stool) and HAEMORRHOIDS (Hemorrhoid) had not resolved. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Treatment information was not provided. On unknown date, the evening after receiving the Moderna COVID-19 vaccine, the patient reported seeing a blood clot in the toilet. The patient stated it looked like hemorrhoids. The patient denied seeking medical care. The patient stated the bleeding is minor but at the time of this report, ongoing. The patient stated having similar minor bleeding approximately 10 years ago. This case concerns a 63-year-old female with PMH of rectal bleeding had serious unexpected events of Rectal hemorrhage, hematochezia and non serious unexpected hemorrhoids. Event onset with unknown latency. after first dose mRNA-1273. Events ongoing. Based on current available information and temporal association between the use of the product and the start date of the event, a causal relationship cannot be excluded.; Sender''s Comments: This case concerns a 63-year-old female with PMH of rectal bleeding had serious unexpected events of Rectal hemorrhage, hematochezia and nonserious unexpected hemorrhoids. Event onset with unknown latency. after first dose mRNA-1273. Events ongoing. Based on current available information and temporal association between the use of the product and the start date of the event, a causal relationship cannot be excluded.

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