National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

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

This is VAERS ID 1775970

Government Disclaimer on use of this data



Case Details

VAERS ID: 1775970 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-10-01
Onset:2021-10-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Body temperature, Lymphadenopathy, Pyrexia, Vaccination site erythema
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (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: Test Date: 20211001; Test Name: Body temperature; Result Unstructured Data: 100.5-100.7 Deg. F
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: Fever of 100.5-100.7 Deg. F; Swollen axillary adenopathy that is 5cm; Redness of injection site of 4cm.; This spontaneous case was reported by an other health care professional and describes the occurrence of PYREXIA (Fever of 100.5-100.7 Deg. F), LYMPHADENOPATHY (Swollen axillary adenopathy that is 5cm) and VACCINATION SITE ERYTHEMA (Redness of injection site of 4cm.) in a 56-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 01-Oct-2021, the patient received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 01-Oct-2021, the patient experienced PYREXIA (Fever of 100.5-100.7 Deg. F), LYMPHADENOPATHY (Swollen axillary adenopathy that is 5cm) and VACCINATION SITE ERYTHEMA (Redness of injection site of 4cm.). The patient was treated with PARACETAMOL (TYLENOL) for Adverse event, at an unspecified dose and frequency. On 03-Oct-2021, PYREXIA (Fever of 100.5-100.7 Deg. F) had resolved. At the time of the report, LYMPHADENOPATHY (Swollen axillary adenopathy that is 5cm) and VACCINATION SITE ERYTHEMA (Redness of injection site of 4cm.) had not resolved. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 01-Oct-2021, Body temperature: 100.5-100.7 (High) 100.5-100.7 Deg. F. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No concomitant medication was provided.


New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1775970


Copyright © 2021 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166