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From the 11/26/2021 release of VAERS data:

This is VAERS ID 1738994

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Case Details

VAERS ID: 1738994 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Foreign  
Vaccinated:0000-00-00
Onset:2021-09-11
Submitted: 0000-00-00
Entered: 2021-09-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Dental paraesthesia, Fatigue, Oropharyngeal pain, Pyrexia, SARS-CoV-2 test
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (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: MIRTAZAPINE; SERTRALINE
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Suspected COVID-19 (Unsure when symptoms started)
Allergies:
Diagnostic Lab Data: Test Name: COVID-19 virus test; Test Result: Negative ; Result Unstructured Data: COVID-19 test
CDC Split Type: GBMODERNATX, INC.MOD20213

Write-up: Fever; Tingling teeth; Sore throat; Fatigue; This case was received via Regulatory Authority (Reference number: GB-MHRA-ADR 25961058) on 19-Sep-2021 and was forwarded to Moderna on 19-Sep-2021. This regulatory authority case was reported by a consumer and describes the occurrence of PYREXIA (Fever), DENTAL PARAESTHESIA (Tingling teeth), OROPHARYNGEAL PAIN (Sore throat) and FATIGUE (Fatigue) in a 34-year-old female patient who received mRNA-1273 (Moderna CoviD-19 Vaccine) for COVID-19 vaccination. The patient''s past medical history included Suspected COVID-19 (Unsure when symptoms started) on 12-Sep-2021. Concomitant products included MIRTAZAPINE and SERTRALINE for an unknown indication. On an unknown date, the patient received dose of mRNA-1273 (Moderna CoviD-19 Vaccine) (unknown route) 1 dosage form. On 11-Sep-2021, the patient experienced PYREXIA (Fever) (seriousness criterion medically significant), DENTAL PARAESTHESIA (Tingling teeth) (seriousness criterion medically significant), OROPHARYNGEAL PAIN (Sore throat) (seriousness criterion medically significant) and FATIGUE (Fatigue) (seriousness criterion medically significant). On 12-Sep-2021, PYREXIA (Fever) had resolved. At the time of the report, DENTAL PARAESTHESIA (Tingling teeth) and OROPHARYNGEAL PAIN (Sore throat) had resolved and FATIGUE (Fatigue) 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. The action taken with mRNA-1273 (Moderna CoviD-19 Vaccine) (Unknown) was unknown. Concomitant products were not provided. Treatment medication were not reported. Company comment This case concerns a 34-year-old, female patient with no relevant medical history, who experienced the unexpected event of Pyrexia, Dental paraesthesia, Oropharyngeal pain and Fatigue. The event occurred after administration of mRNA-1273. (Date and dose sequence of the vaccine are not provided). The benefit-risk relationship of mRNA-1273 is not affected by this report. Event seriousness assessed as per Regulatory Authority reporting and retained for consistency with the RA report.; Sender''s Comments: This case concerns a 34-year-old, female patient with no relevant medical history, who experienced the unexpected event of Pyrexia, Dental paraesthesia, Oropharyngeal pain and Fatigue. The event occurred after administration of mRNA-1273. (Date and dose sequence of the vaccine are not provided). The benefit-risk relationship of mRNA-1273 is not affected by this report. Event seriousness assessed as per Regulatory Authority reporting and retained for consistency with the RA report.


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