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From the 7/23/2021 release of VAERS data:

Found 1 cases where Age is 12-or-more-and-under-18 and Vaccine is COVID19 and Manufacturer is MODERNA and Symptom is Cerebral venous sinus thrombosis or Cerebral venous thrombosis or Coagulopathy or Deep vein thrombosis or Disseminated intravascular coagulation or Embolism or Idiopathic thrombocytopenic purpura or Immune thrombocytopenia or Immune thrombocytopenic purpura or Ischaemic stroke or Myocardial infarction or Petechiae or Pulmonary embolism or Purpura or Thrombocytopenia or Thrombosis or Vasculitis

Table

   
AgeCountPercent
17-44 Years1100%
TOTAL1100%



Case Details

VAERS ID: 1396865 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: Foreign  
Vaccinated:2021-04-02
Onset:2021-04-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 3000495 / UNK - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Headache, Paraesthesia, Product administered to patient of inappropriate age, Thrombosis
SMQs:, Peripheral neuropathy (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (broad), Guillain-Barre syndrome (broad), Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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:
CDC Split Type: DEMODERNATX, INC.MOD20212

Write-up: Thrombosis; Paraesthesia; Headache; Inappropriate age at vaccine administration; This regulatory authority case was reported by a consumer and describes the occurrence of THROMBOSIS (Thrombosis), PARAESTHESIA (Paraesthesia) and HEADACHE (Headache) in a 17-year-old male patient who received mRNA-1273 (COVID 19 Vaccine Moderna) (batch no. 3000495) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 02-Apr-2021, the patient received dose of mRNA-1273 (COVID 19 Vaccine Moderna) (unknown route) unknown. On 02-Apr-2021, the patient experienced THROMBOSIS (Thrombosis) (seriousness criteria hospitalization prolonged and medically significant), PARAESTHESIA (Paraesthesia) (seriousness criterion hospitalization prolonged), HEADACHE (Headache) (seriousness criterion hospitalization prolonged) and PRODUCT ADMINISTERED TO PATIENT OF INAPPROPRIATE AGE (Inappropriate age at vaccine administration). At the time of the report, THROMBOSIS (Thrombosis), PARAESTHESIA (Paraesthesia) and HEADACHE (Headache) had resolved and PRODUCT ADMINISTERED TO PATIENT OF INAPPROPRIATE AGE (Inappropriate age at vaccine administration) outcome was unknown. The action taken with mRNA-1273 (COVID 19 Vaccine Moderna) (Unknown) was unknown. Concomitant medication use was not provided. No Treatment information was provided. Based on the current available information and temporal association between the use of the product and the thrombosis, headache and paresthesia, a causal relationship cannot be excluded. Event terms, onset dates and outcomes captured per SD Authority reporting. Event added tp reflect that the patient was below age specified in label. Events seriousness per assessment by Authority and per IME list; Sender''s Comments: Based on the current available information and temporal association between the use of the product and the thrombosis, headache and paresthesia, a causal relationship cannot be excluded. Event terms, onset dates and outcomes captured per SD Authority reporting. Event added tp reflect that the patient was below age specified in label. Events seriousness per assessment by Authority and per IME list


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https://medalerts.org/vaersdb/findfield.php?TABLE=ON&GROUP1=AGE&EVENTS=ON&SYMPTOMS[]=Cerebral+venous+sinus+thrombosis+%2810083037%29&SYMPTOMS[]=Cerebral+venous+thrombosis+%2810008138%29&SYMPTOMS[]=Coagulopathy+%2810009802%29&SYMPTOMS[]=Deep+vein+thrombosis+%2810051055%29&SYMPTOMS[]=Disseminated+intravascular+coagulation+%2810013442%29&SYMPTOMS[]=Embolism+%2810061169%29&SYMPTOMS[]=Idiopathic+thrombocytopenic+purpura+%2810021245%29&SYMPTOMS[]=Immune+thrombocytopenia+%2810083842%29&SYMPTOMS[]=Immune+thrombocytopenic+purpura+%2810074667%29&SYMPTOMS[]=Ischaemic+stroke+%2810061256%29&SYMPTOMS[]=Myocardial+infarction+%2810028596%29&SYMPTOMS[]=Petechiae+%2810034754%29&SYMPTOMS[]=Pulmonary+embolism+%2810037377%29&SYMPTOMS[]=Purpura+%2810037549%29&SYMPTOMS[]=Thrombocytopenia+%2810043554%29&SYMPTOMS[]=Thrombosis+%2810043607%29&SYMPTOMS[]=Vasculitis+%2810047115%29&VAX=COVID19&VAXMAN=MODERNA&WhichAge=range&LOWAGE=12&HIGHAGE=18


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