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This is VAERS ID 1404416

History of Changes from the VAERS Wayback Machine

First Appeared on 7/23/2021

VAERS ID: 1404416
VAERS Form:2
Age:33.0
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 - / UNK - / -

Administered by: Unknown      Purchased by: ??
Symptoms: Chills, Diarrhoea, Fatigue, Nausea, 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: Lactation decreased
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': GBMODERNATX, INC.MOD20212

Write-up: Diarrhea; Nausea; Fever; Chills; Fatigue; This regulatory authority case was reported by a consumer and describes the occurrence of DIARRHOEA (Diarrhea) in a 33-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. The patient''s past medical history included Lactation decreased. On 04-Jun-2021, the patient received dose of mRNA-1273 (Moderna CoviD-19 Vaccine) (unknown route) 1 dosage form. On 04-Jun-2021, the patient experienced DIARRHOEA (Diarrhea) (seriousness criterion medically significant), NAUSEA (Nausea), PYREXIA (Fever), CHILLS (Chills) and FATIGUE (Fatigue). On 06-Jun-2021, DIARRHOEA (Diarrhea), PYREXIA (Fever), CHILLS (Chills) and FATIGUE (Fatigue) had resolved. At the time of the report, NAUSEA (Nausea) was resolving. The action taken with mRNA-1273 (Moderna CoviD-19 Vaccine) (Unknown Route) was unknown. Patient not had symptoms associated with COVID-19 and was not enrolled in clinical trial. She was a very distressing 48 hrs and not something she wish to experience again. Patient was hesitant for her 2nd vaccine now. She had not tested positive for COVID-19 since having the vaccine 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.; 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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