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This is VAERS ID 1404440

History of Changes from the VAERS Wayback Machine

First Appeared on 7/23/2021

VAERS ID: 1404440
VAERS Form:2
Age:45.0
Sex:Female
Location:Foreign
Vaccinated:2021-05-15
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: Rheumatoid arthritis

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': GBMODERNATX, INC.MOD20212

Write-up: Arthritis rheumatoid; This regulatory authority case was reported by a consumer and describes the occurrence of RHEUMATOID ARTHRITIS (Arthritis rheumatoid) in a 45-year-old female patient who received mRNA-1273 (Moderna CoviD-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 15-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 RHEUMATOID ARTHRITIS (Arthritis rheumatoid) (seriousness criterion medically significant). At the time of the report, RHEUMATOID ARTHRITIS (Arthritis rheumatoid) had not resolved. The action taken with mRNA-1273 (Moderna CoviD-19 Vaccine) (Unknown) was unknown. No concomitant medications reported. The patient has a history of a negative COVID-19 test on an unspecified date. No treatment details reported. 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. Very limited information regarding this event has been provided at this time. No further information is expected at this time.; 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. Very limited information regarding this event has been provided at this time. No further information is expected at this time.

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