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This is VAERS ID 1473547

History of Changes from the VAERS Wayback Machine

First Appeared on 7/16/2021

VAERS ID: 1473547
VAERS Form:2
Age:18.0
Sex:Female
Location:Foreign
Vaccinated:2021-07-01
Onset:2021-07-02
Submitted:0000-00-00
Entered:2021-07-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

Administered by: Unknown      Purchased by: ??
Symptoms: Dizziness, Headache, Nausea, Vision blurred, Sudden hearing loss, 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:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Lactation decreased
Allergies:
Diagnostic Lab Data: Test Date: 20210618; Test Name: COVID-19 virus test; Test Result: Negative ; Result Unstructured Data: Negative; Comments: No - Negative COVID-19 test
CDC 'Split Type': GBMODERNATX, INC.MOD20212

Write-up: Sudden hearing loss, unspecified; Blurred vision; Dizziness; Nauseous; Headache; This regulatory authority case was reported by a consumer and describes the occurrence of SUDDEN HEARING LOSS (Sudden hearing loss, unspecified), VISION BLURRED (Blurred vision), DIZZINESS (Dizziness), NAUSEA (Nauseous) and HEADACHE (Headache) in an 18-year-old female patient who received mRNA-1273 (Moderna CoviD-19 Vaccine) for COVID-19 vaccination. The patient''s past medical history included Lactation decreased. On 01-Jul-2021, the patient received first dose of mRNA-1273 (Moderna CoviD-19 Vaccine) (Intramuscular) 1 dosage form. On 02-Jul-2021, the patient experienced SUDDEN HEARING LOSS (Sudden hearing loss, unspecified) (seriousness criterion medically significant), VISION BLURRED (Blurred vision) (seriousness criterion medically significant), DIZZINESS (Dizziness) (seriousness criterion medically significant), NAUSEA (Nauseous) (seriousness criterion medically significant) and HEADACHE (Headache) (seriousness criterion medically significant). On 02-Jul-2021, SUDDEN HEARING LOSS (Sudden hearing loss, unspecified) had resolved. At the time of the report, VISION BLURRED (Blurred vision) was resolving and DIZZINESS (Dizziness), NAUSEA (Nauseous) and HEADACHE (Headache) had not resolved. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 18-Jun-2021, SARS-CoV-2 test: negative (Negative) Negative. The action taken with mRNA-1273 (Moderna CoviD-19 Vaccine) (Intramuscular) was unknown. Concomitant products were not provided. Treatment medication were not reported. Patient reported that sometimes when standing sudden loss of hearing and blurred vision. 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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