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This is VAERS ID 1249637

History of Changes from the VAERS Wayback Machine

First Appeared on 4/30/2021

VAERS ID: 1249637
VAERS Form:2
Age:56.0
Sex:Female
Location:California
Vaccinated:2021-04-12
Onset:2021-04-12
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: Asthenia, Dyspnoea at rest, Fatigue, Feeling abnormal, Head discomfort, Myalgia, Neck pain, Pyrexia

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: Arthritis; COPD; Multiple sclerosis spinal cord lesion; Osteoporosis
Allergies:
Diagnostic Lab Data: Test Date: 20210412; Test Name: fever; Result Unstructured Data: 100 F
CDC 'Split Type': USMODERNATX, INC.MOD20210

Write-up: no energy; pain all over body, feel like train wreck; pain all over body, feel like train wreck / every muscle in their body hurt; temperature 100F; patient is also very tired; shortness of breath; night of vaccination administration patient felt discomfort in neck and head on left side; night of vaccination administration patient felt discomfort in neck and head on left side; This spontaneous case was reported by a consumer (subsequently medically confirmed) and describes the occurrence of DYSPNOEA AT REST (shortness of breath) in a 56-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. Concurrent medical conditions included Arthritis, Osteoporosis, Multiple sclerosis spinal cord lesion and COPD. On 12-Apr-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 12-Apr-2021, the patient experienced DYSPNOEA AT REST (shortness of breath) (seriousness criterion medically significant), HEAD DISCOMFORT (night of vaccination administration patient felt discomfort in neck and head on left side), NECK PAIN (night of vaccination administration patient felt discomfort in neck and head on left side), MYALGIA (pain all over body, feel like train wreck / every muscle in their body hurt), PYREXIA (temperature 100F) and FATIGUE (patient is also very tired). On an unknown date, the patient experienced ASTHENIA (no energy) and FEELING ABNORMAL (pain all over body, feel like train wreck). At the time of the report, DYSPNOEA AT REST (shortness of breath), HEAD DISCOMFORT (night of vaccination administration patient felt discomfort in neck and head on left side), NECK PAIN (night of vaccination administration patient felt discomfort in neck and head on left side), ASTHENIA (no energy), FEELING ABNORMAL (pain all over body, feel like train wreck), MYALGIA (pain all over body, feel like train wreck / every muscle in their body hurt), PYREXIA (temperature 100F) and FATIGUE (patient is also very tired) had not resolved. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 12-Apr-2021, Pyrexia: 100 (High) 100 F. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. There is no concomitant list provided. Treatment information was not provided. Company Comment Based on current available information and the temporal association between product use and the start date of the events a causal relationship cannot be excluded.


Changed on 5/7/2021

VAERS ID: 1249637 Before After
VAERS Form:2
Age:56.0
Sex:Female
Location:California
Vaccinated:2021-04-12
Onset:2021-04-12
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: Asthenia, Dyspnoea at rest, Fatigue, Feeling abnormal, Head discomfort, Myalgia, Neck pain, Pyrexia

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: Arthritis; COPD; Multiple sclerosis spinal cord lesion; Osteoporosis
Allergies:
Diagnostic Lab Data: Test Date: 20210412; Test Name: fever; Result Unstructured Data: 100 F
CDC 'Split Type': USMODERNATX, INC.MOD20210

Write-up: no energy; pain all over body, feel like train wreck; pain all over body, feel like train wreck / every muscle in their body hurt; temperature 100F; patient is also very tired; shortness of breath; night of vaccination administration patient felt discomfort in neck and head on left side; night of vaccination administration patient felt discomfort in neck and head on left side; This spontaneous case was reported by a consumer (subsequently medically confirmed) and describes the occurrence of DYSPNOEA AT REST (shortness of breath) in a 56-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. Concurrent medical conditions included Arthritis, Osteoporosis, Multiple sclerosis spinal cord lesion and COPD. On 12-Apr-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 12-Apr-2021, the patient experienced DYSPNOEA AT REST (shortness of breath) (seriousness criterion medically significant), HEAD DISCOMFORT (night of vaccination administration patient felt discomfort in neck and head on left side), NECK PAIN (night of vaccination administration patient felt discomfort in neck and head on left side), MYALGIA (pain all over body, feel like train wreck / every muscle in their body hurt), PYREXIA (temperature 100F) and FATIGUE (patient is also very tired). On an unknown date, the patient experienced ASTHENIA (no energy) and FEELING ABNORMAL (pain all over body, feel like train wreck). At the time of the report, DYSPNOEA AT REST (shortness of breath), HEAD DISCOMFORT (night of vaccination administration patient felt discomfort in neck and head on left side), NECK PAIN (night of vaccination administration patient felt discomfort in neck and head on left side), ASTHENIA (no energy), FEELING ABNORMAL (pain all over body, feel like train wreck), MYALGIA (pain all over body, feel like train wreck / every muscle in their body hurt), PYREXIA (temperature 100F) and FATIGUE (patient is also very tired) had not resolved. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 12-Apr-2021, Pyrexia: 100 (High) 100 F. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. There is no concomitant list provided. Treatment information was not provided. Company Comment Based on current available information and the temporal association between product use and the start date of the events a causal relationship cannot be excluded.


Changed on 5/14/2021

VAERS ID: 1249637 Before After
VAERS Form:2
Age:56.0
Sex:Female
Location:California
Vaccinated:2021-04-12
Onset:2021-04-12
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: Asthenia, Dyspnoea at rest, Fatigue, Feeling abnormal, Head discomfort, Myalgia, Neck pain, Pyrexia

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: Arthritis; COPD; Multiple sclerosis spinal cord lesion; Osteoporosis
Allergies:
Diagnostic Lab Data: Test Date: 20210412; Test Name: fever; Result Unstructured Data: 100 F
CDC 'Split Type': USMODERNATX, INC.MOD20210

Write-up: no energy; pain all over body, feel like train wreck; pain all over body, feel like train wreck / every muscle in their body hurt; temperature 100F; patient is also very tired; shortness of breath; night of vaccination administration patient felt discomfort in neck and head on left side; night of vaccination administration patient felt discomfort in neck and head on left side; This spontaneous case was reported by a consumer (subsequently medically confirmed) and describes the occurrence of DYSPNOEA AT REST (shortness of breath) in a 56-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. Concurrent medical conditions included Arthritis, Osteoporosis, Multiple sclerosis spinal cord lesion and COPD. On 12-Apr-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 12-Apr-2021, the patient experienced DYSPNOEA AT REST (shortness of breath) (seriousness criterion medically significant), HEAD DISCOMFORT (night of vaccination administration patient felt discomfort in neck and head on left side), NECK PAIN (night of vaccination administration patient felt discomfort in neck and head on left side), MYALGIA (pain all over body, feel like train wreck / every muscle in their body hurt), PYREXIA (temperature 100F) and FATIGUE (patient is also very tired). On an unknown date, the patient experienced ASTHENIA (no energy) and FEELING ABNORMAL (pain all over body, feel like train wreck). At the time of the report, DYSPNOEA AT REST (shortness of breath), HEAD DISCOMFORT (night of vaccination administration patient felt discomfort in neck and head on left side), NECK PAIN (night of vaccination administration patient felt discomfort in neck and head on left side), ASTHENIA (no energy), FEELING ABNORMAL (pain all over body, feel like train wreck), MYALGIA (pain all over body, feel like train wreck / every muscle in their body hurt), PYREXIA (temperature 100F) and FATIGUE (patient is also very tired) had not resolved. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 12-Apr-2021, Pyrexia: 100 (High) 100 F. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. There is no concomitant list provided. Treatment information was not provided. Company Comment Based on current available information and the temporal association between product use and the start date of the events a causal relationship cannot be excluded.

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