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This is VAERS ID 1473896

History of Changes from the VAERS Wayback Machine

First Appeared on 7/16/2021

VAERS ID: 1473896
VAERS Form:2
Age:18.0
Sex:Female
Location:Foreign
Vaccinated:2021-07-01
Onset:2021-07-01
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: Headache, Pyrexia, SARS-CoV-2 test positive, 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; Suspected COVID-19 (Unsure when symptoms started; Unsure when symptoms stopped)
Allergies:
Diagnostic Lab Data: Test Name: COVID-19 virus test; Test Result: Positive ; Result Unstructured Data: Positive
CDC 'Split Type': GBMODERNATX, INC.MOD20212

Write-up: Covid-19 test positive; Fever; Fever; Headache; This regulatory authority case was reported by a consumer and describes the occurrence of the first episode of PYREXIA (Fever) and HEADACHE (Headache) in an 18-year-old female patient who received mRNA-1273 (COVID-19 Vaccine Moderna) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. The patient''s past medical history included Lactation decreased and Suspected COVID-19 (Unsure when symptoms started; Unsure when symptoms stopped). On 01-Jul-2021, the patient received first dose of mRNA-1273 (COVID-19 Vaccine Moderna) (Intramuscular) 1 dosage form. On 01-Jul-2021, the patient experienced the first episode of PYREXIA (Fever) (seriousness criterion medically significant), HEADACHE (Headache) (seriousness criterion medically significant) and the second episode of PYREXIA (Fever). On an unknown date, the patient experienced SARS-COV-2 TEST POSITIVE (Covid-19 test positive). At the time of the report, HEADACHE (Headache) and the last episode of PYREXIA (Fever) had not resolved and SARS-COV-2 TEST POSITIVE (Covid-19 test positive) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, SARS-CoV-2 test: positive (Positive) Positive. The action taken with mRNA-1273 (COVID-19 Vaccine Moderna) (Intramuscular) was unknown. No concomitant medications were reported. 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 fever and headache, a causal relationship cannot be excluded. Events seriousness was assessed as per source document by regulatory authority. Based on the mechanism of action of mRNA-1273 causal association between the event of SARS-CoV-2 test positive and mRNA-1273 is assessed as not applicable; 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 fever and headache, a causal relationship cannot be excluded. Events seriousness was assessed as per source document by regulatory authority. Based on the mechanism of action of mRNA-1273 causal association between the event of SARS-CoV-2 test positive and mRNA-1273 is assessed as not applicable

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