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This is VAERS ID 1404399

History of Changes from the VAERS Wayback Machine

First Appeared on 7/23/2021

VAERS ID: 1404399
VAERS Form:2
Age:
Sex:Female
Location:Foreign
Vaccinated:2021-05-24
Onset:2021-06-01
Submitted:0000-00-00
Entered:2021-06-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

Administered by: Unknown      Purchased by: ??
Symptoms: Urticaria, Vaccination site erythema, 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: BECLOMETHASONE [BECLOMETASONE]; VENLAFAXINE
Current Illness: Mixed anxiety and depressive disorder
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210506; Test Name: COVID-19 virus test; Test Result: Negative ; Result Unstructured Data: negative
CDC 'Split Type': GBMODERNATX, INC.MOD20212

Write-up: red splotches; Hives; This regulatory authority case was reported by a consumer and describes the occurrence of VACCINATION SITE ERYTHEMA (red splotches) and URTICARIA (Hives) in a female patient of an unknown age who received mRNA-1273 (Moderna CoviD-19 Vaccine) for COVID-19 vaccination. Concurrent medical conditions included Mixed anxiety and depressive disorder. Concomitant products included BECLOMETHASONE [BECLOMETASONE] and VENLAFAXINE for Mixed anxiety and depressive disorder. On 24-May-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 URTICARIA (Hives) (seriousness criterion medically significant). On an unknown date, the patient experienced VACCINATION SITE ERYTHEMA (red splotches) (seriousness criterion medically significant). On 05-Jun-2021, URTICARIA (Hives) was resolving. At the time of the report, VACCINATION SITE ERYTHEMA (red splotches) was resolving. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 06-May-2021, SARS-CoV-2 test: no - negative covid-19 test (Negative) negative. The action taken with mRNA-1273 (Moderna CoviD-19 Vaccine) (Unknown) was unknown. The patient experienced red splotches on skin, not generally itchy (less than 5 times has it felt itchy) appeared suddenly and started spreading really quickly. Called GP and submitted photos. Antihistamines were given as treatment. Patient has not tested positive for COVID-19 since having the vaccine. 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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