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From the 9/17/2021 release of VAERS data:

This is VAERS ID 1423038



Case Details

VAERS ID: 1423038 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-04-26
Onset:2021-06-04
   Days after vaccination:39
Submitted: 0000-00-00
Entered: 2021-06-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 648B21A / 2 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Dyskinesia, Seizure
SMQs:, Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Convulsions (narrow), Dyskinesia (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: convulsions; Uncontrollable movement on her face / Uncontrollable movement of entire body; This spontaneous case was reported by a consumer and describes the occurrence of SEIZURE (convulsions) in a 26-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 648B21A and 037C21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 26-Apr-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 28-May-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 04-Jun-2021, the patient experienced SEIZURE (convulsions) (seriousness criterion medically significant) and DYSKINESIA (Uncontrollable movement on her face / Uncontrollable movement of entire body). The patient was treated with DIPHENHYDRAMINE HYDROCHLORIDE (BENADRYL [DIPHENHYDRAMINE HYDROCHLORIDE]) at a dose of 25 mg. At the time of the report, SEIZURE (convulsions) and DYSKINESIA (Uncontrollable movement on her face / Uncontrollable movement of entire body) had not resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. Concomitant product use was not provided by the reporter. It was reported that the patient started experiencing uncontrollable movement on her face and entire body, it like convulsions almost. The pharmacist was not sure what she could use to help it but she was told to use Benadryl 25mg. She is still having the symptoms bad. This case concerns a 26-year-old female with a serious unexpected event of seizure, and non-serious dyskinesia. Event latency 7 days after second dose mRNA-1273. Based on 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: This case concerns a 26-year-old female with a serious unexpected event of seizure, and nonserious dyskinesia. Event latency 7 days after second dose mRNA-1273. Based on 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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