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This is VAERS ID 1404117

History of Changes from the VAERS Wayback Machine

First Appeared on 7/23/2021

VAERS ID: 1404117
VAERS Form:2
Age:30.0
Sex:Female
Location:Foreign
Vaccinated:2021-06-04
Onset:2021-06-04
Submitted:0000-00-00
Entered:2021-06-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 3002332 / 1 - / OT

Administered by: Unknown      Purchased by: ??
Symptoms: Pain, Sleep disorder, SARS-CoV-2 test

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: Lactation decreased
Allergies:
Diagnostic Lab Data: Test Date: 20210320; Test Name: COVID-19 virus test; Test Result: Negative ; Result Unstructured Data: Negative COVID-19 test
CDC 'Split Type': GBMODERNATX, INC.MOD20212

Write-up: Pain; sleep disturbance; This regulatory authority case was reported by a consumer and describes the occurrence of PAIN (Pain) in a 30-year-old female patient who received mRNA-1273 (Moderna CoviD-19 Vaccine) (batch no. 3002332) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. The patient''s past medical history included Lactation decreased. On 04-Jun-2021, the patient received first dose of mRNA-1273 (Moderna CoviD-19 Vaccine) (Intramuscular) 1 dosage form. On 04-Jun-2021, the patient experienced PAIN (Pain) (seriousness criterion medically significant) and SLEEP DISORDER (sleep disturbance). At the time of the report, PAIN (Pain) had not resolved and SLEEP DISORDER (sleep disturbance) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 20-Mar-2021, SARS-CoV-2 test: negative (Negative) Negative COVID-19 test. The action taken with mRNA-1273 (Moderna CoviD-19 Vaccine) (Intramuscular) was unknown. Concomitant product use was not provided by the reporter. The patient had non stop pain in her left arm (at the site of the injection) ever since the vaccination. A couple of hours after the vaccine the pain was so much that she could not really lift her arm . The only non-painful position was with it limp by her side, sitting/standing upright. The pain was about a 6 out of 10 and it stopped her from sleeping properly. The patient did not have symptoms associated with COVID-19. The patient was not enrolled in a clinical trial. The patient was not currently breastfeeding. The patient did not tested positive for COVID-19 since having the vaccine. No treatment information was provided. Based on the 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: Based on the 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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