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This is VAERS ID 1416212

History of Changes from the VAERS Wayback Machine

First Appeared on 7/23/2021

VAERS ID: 1416212
VAERS Form:2
Age:60.0
Sex:Female
Location:Foreign
Vaccinated:2021-06-01
Onset:2021-06-03
Submitted:0000-00-00
Entered:2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 3002917 / UNK - / OT

Administered by: Unknown      Purchased by: ??
Symptoms: Pyrexia, Urine output, Urine output decreased

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210603; Test Name: Urinary output; Result Unstructured Data: Urinary output diminished
CDC 'Split Type': ITMODERNATX, INC.MOD20212

Write-up: urinary output diminished; This regulatory authority case was reported by a pharmacist and describes the occurrence of PYREXIA and URINE OUTPUT DECREASED (urinary output diminished) in a 60-year-old female patient who received mRNA-1273 (COVID 19 Vaccine Moderna) (batch no. 3002917) for COVID-19 vaccination. No Medical History information was reported. On 01-Jun-2021, the patient received dose of mRNA-1273 (COVID 19 Vaccine Moderna) (Intramuscular) .5 milliliter in total. On 03-Jun-2021, the patient experienced PYREXIA (seriousness criterion hospitalization) and URINE OUTPUT DECREASED (urinary output diminished) (seriousness criterion hospitalization). The patient was hospitalized on 03-Jun-2021 due to PYREXIA and URINE OUTPUT DECREASED. At the time of the report, PYREXIA and URINE OUTPUT DECREASED (urinary output diminished) was resolving. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 03-Jun-2021, Urine output: urinary output diminished (Low) Urinary output diminished. The action taken with mRNA-1273 (COVID 19 Vaccine Moderna) (Intramuscular) was unknown. For mRNA-1273 (COVID 19 Vaccine Moderna) (Intramuscular), the reporter did not provide any causality assessments. Concomitant medication were not provided.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 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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