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This is VAERS ID 1729186

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First Appeared on 10/15/2021

VAERS ID: 1729186
VAERS Form:2
Age:26.0
Sex:Female
Location:Foreign
Vaccinated:2021-09-13
Onset:2021-09-13
Submitted:0000-00-00
Entered:2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

Administered by: Unknown      Purchased by: ??
Symptoms: Headache, Pain, Palpitations, Vomiting, 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:
Allergies:
Diagnostic Lab Data: Test Name: COVID-19 virus test; Test Result: Negative ; Result Unstructured Data: No - Negative COVID-19 test
CDC 'Split Type': GBMODERNATX, INC.MOD20213

Write-up: aches all over body; headache; palpitations; Vomiting; Heart pounding; This case was received via Regulatory Authority (Reference number: GB-MHRA-ADR 25940237) on 15-Sep-2021 and was forwarded to Moderna on 15-Sep-2021. This regulatory authority case was reported by a consumer and describes the occurrence of PAIN (aches all over body), HEADACHE (headache), PALPITATIONS (palpitations), PALPITATIONS (Heart pounding) and VOMITING (Vomiting) in a 26-year-old female patient who received mRNA-1273 (Moderna CoviD-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 13-Sep-2021, the patient received second dose of mRNA-1273 (Moderna CoviD-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On an unknown date, the patient received first dose of mRNA-1273 (Moderna CoviD-19 Vaccine) (unknown route) 1 dosage form. On 13-Sep-2021, the patient experienced PALPITATIONS (Heart pounding) (seriousness criterion medically significant). On 14-Sep-2021, the patient experienced VOMITING (Vomiting) (seriousness criterion medically significant). On an unknown date, the patient experienced PAIN (aches all over body) (seriousness criterion medically significant), HEADACHE (headache) (seriousness criterion medically significant) and PALPITATIONS (palpitations) (seriousness criterion medically significant). At the time of the report, PAIN (aches all over body), HEADACHE (headache) and PALPITATIONS (palpitations) outcome was unknown, PALPITATIONS (Heart pounding) had not resolved and VOMITING (Vomiting) was resolving. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, SARS-CoV-2 test: no - negative covid-19 test (Negative) No - Negative COVID-19 test. The action taken with mRNA-1273 (Moderna CoviD-19 Vaccine) (Unknown) was unknown. Concomitant medications was not reported. Treatment history was not reported. Patient had not tested positive for COVID-19 since having the vaccine. Company Comment: This case concerns a 26-year-old, female patient with no relevant medical history, who experienced the unexpected events of pain, headache, palpitations (palpitations and heart pounding) and vomiting. The events of palpitations (palpitations and heart pounding) occurred the same day after the second dose of mRNA 1273, the event of vomiting occurred the next day after the second dose of mRNA 1273, the onset date for the events of pain, and headache is not known. The rechallenge was unknown and no information about the second dose was disclosed. The reporter assessed the events as related to the product. The benefit-risk relationship of mRNA-1273 in not affected by this report. Event seriousness assessed as per Regulatory Authority reporting,; Sender''s Comments: This case concerns a 26-year-old, female patient with no relevant medical history, who experienced the unexpected events of pain, headache, palpitations (palpitations and heart pounding) and vomiting. The events of palpitations (palpitations and heart pounding) occurred the same day after the second dose of mRNA 1273, the event of vomiting occurred the next day after the second dose of mRNA 1273, the onset date for the events of pain, and headache is not known. The rechallenge was unknown and no information about the second dose was disclosed. The reporter assessed the events as related to the product. The benefit-risk relationship of mRNA-1273 in not affected by this report. Event seriousness assessed as per Regulatory Authority reporting,

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