National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 1334809

History of Changes from the VAERS Wayback Machine

First Appeared on 5/21/2021

VAERS ID: 1334809
VAERS Form:2
Age:67.0
Sex:Female
Location:Texas
Vaccinated:2021-01-01
Onset:2021-05-04
Submitted:0000-00-00
Entered:2021-05-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / -

Administered by: Unknown      Purchased by: ??
Symptoms: Eye haemorrhage, Ocular hyperaemia, Swelling of eyelid

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:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': USMODERNATX, INC.MOD20211

Write-up: Burst blood vessel hemorrhage and is small; eyelids were a little bit swollen; Right eye is red; This spontaneous case was reported by a consumer and describes the occurrence of EYE HAEMORRHAGE (Burst blood vessel hemorrhage and is small) in a 67-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. No Medical History information was reported. In January 2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. In February 2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1. On 04-May-2021, the patient experienced EYE HAEMORRHAGE (Burst blood vessel hemorrhage and is small) (seriousness criterion medically significant), SWELLING OF EYELID (eyelids were a little bit swollen) and OCULAR HYPERAEMIA (Right eye is red). At the time of the report, EYE HAEMORRHAGE (Burst blood vessel hemorrhage and is small), SWELLING OF EYELID (eyelids were a little bit swollen) and OCULAR HYPERAEMIA (Right eye is red) outcome was unknown. Not Provided Concomitant product use was not provided by the reporter. Treatment information was not provided. Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded. This case was linked to MOD-2021-109540, MOD-2021-109560 (E2B Linked Report).; Sender''s Comments: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded. MOD-2021-109540: MOD-2021-109560:

New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1334809&WAYBACKHISTORY=ON


Copyright © 2021 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166