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This is VAERS ID 1404346

History of Changes from the VAERS Wayback Machine

First Appeared on 7/23/2021

VAERS ID: 1404346
VAERS Form:2
Age:32.0
Sex:Female
Location:Foreign
Vaccinated:2021-06-01
Onset:2021-06-01
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: Influenza, Myalgia, 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: Suspected COVID-19
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': GBMODERNATX, INC.MOD20212

Write-up: Flu; Muscle ache; Fever; This regulatory authority case was reported by a consumer and describes the occurrence of INFLUENZA (Flu), PYREXIA (Fever) and MYALGIA (Muscle ache) in a 32-year-old female patient who received mRNA-1273 (Moderna CoviD-19 Vaccine) (batch no. 3002332) for COVID-19 vaccination. The patient''s past medical history included Suspected COVID-19 from 16-Mar-2020 to 21-Mar-2020. On 01-Jun-2021, the patient received first dose of mRNA-1273 (Moderna CoviD-19 Vaccine) (unknown route) 1 dosage form. On 01-Jun-2021, the patient experienced PYREXIA (Fever) (seriousness criterion medically significant). On 02-Jun-2021, the patient experienced INFLUENZA (Flu) (seriousness criterion medically significant) and MYALGIA (Muscle ache) (seriousness criterion medically significant). At the time of the report, INFLUENZA (Flu) and MYALGIA (Muscle ache) was resolving and PYREXIA (Fever) had not resolved. The action taken with mRNA-1273 (Moderna CoviD-19 Vaccine) (Unknown) was unknown. Relevant concomitant medications was not provided. Patient not had a COVID-19 test, Patient is not enrolled in clinical trial and patient is not currently breastfeeding. Patient has not tested positive for COVID-19 since having the vaccine. Treatment medication was not provided. Company Comment: 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.; 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.

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