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VAERS Report 2136764

Case Report Section

Détails du rapport Vaer

Âge: 54 ans

Genre: Female

Région : Outside US

Patient décédé?
Non
Renseignements sur les vaccins

Nom: COVID19 (COVID19 (MODERNA))

Type : Coronavirus 2019 vaccine

Fabricant: MODERNA

Lot: unknown


Date de réception du rapport
2022-02-24
Date à laquelle le formulaire est complèté
Date de vaccination
2022-01-17
Date d’apparition
1
Nombre de jours (date d’apparition – date de vaccination)
1
Description de l’événement indésirable

headache; malaise; fever; stuffy; suspicion pulmonary embolism and dimeers far too high; fatigue; this case was received (reference number: nl-lrb-00782776) on 18-feb-2022 and was forwarded to moderna on 18-feb-2022. this regulatory authority case was reported by a consumer and describes the occurrence of headache (headache), malaise (malaise), pyrexia (fever), dyspnoea (stuffy), pulmonary embolism (suspicion pulmonary embolism and dimeers far too high) and fatigue (fatigue) in a 54-year-old female patient who received mrna-1273 (spikevax) for covid-19 vaccination. concurrent medical conditions included pulmonary embolism (family history: false). concomitant products included corticosteroid nos for an unknown indication. on 17-jan-2022, the patient received dose of mrna-1273 (spikevax) (unknown route) 1 dosage form. on 18-jan-2022, the patient experienced headache (headache) (seriousness criterion hospitalization), malaise (malaise) (seriousness criterion hospitalization), pyrexia (fever) (seriousness criterion hospitalization), dyspnoea (stuffy) (seriousness criterion hospitalization), pulmonary embolism (suspicion pulmonary embolism and dimeers far too high) (seriousness criterion hospitalization) and fatigue (fatigue) (seriousness criterion hospitalization). at the time of the report, headache (headache), malaise (malaise), pyrexia (fever), dyspnoea (stuffy), pulmonary embolism (suspicion pulmonary embolism and dimeers far too high) and fatigue (fatigue) had not resolved. diagnostic results (normal ranges are provided in parenthesis if available): on an unknown date, fibrin d dimer: increased (high) increased. treatment information was not provided. company comment: this regulatory case concerns a 54-year-old female patient with relevant medical history of pulmonary embolism, who experienced the unexpected serious (hospitalisation) event of headache, malaise, fever, dyspnoea, pulmonary embolism (reported as suspicion pulmonary embolism and dimers far too high) and fatigue on next day following the receipt of first dose of mrna-1273 vaccine. medical history of pulmonary embolism could be a risk factor for the events pulmonary embolism and dyspnoea. the benefit-risk relationship of mrna-1273 is not affected by this report. seriousness of the events retained as per regulatory authority reporting.; sender's comments: this regulatory case concerns a 54-year-old female patient with relevant medical history of pulmonary embolism, who experienced the unexpected serious (hospitalisation) event of headache, malaise, fever, dyspnoea, pulmonary embolism (reported as suspicion pulmonary embolism and dimers far too high) and fatigue on next day following the receipt of first dose of mrna-1273 vaccine. medical history of pulmonary embolism could be a risk factor for the events pulmonary embolism and dyspnoea. the benefit-risk relationship of mrna-1273 is not affected by this report. seriousness of the events retained as per regulatory authority reporting

Données de laboratoire
test name: fibrin d dimer; result unstructured data: increased
Liste des symptômes
malaise fatigue headache dyspnoea pyrexia pulmonary embolism fibrin d dimer
Patient décédé?
Non
Date de décès
N/A
Anomalie congénitale
false
Vaccin administré par :
Unknown
Vaccin acheté par :
Inconnu
Visite d’un patient à l’urgence?
Non
Patient hospitalisé?
Oui
Séjour à l’hôpital
Non
Nombre de jours à l’hôpital
Non spécifié
Invalidité permanente?
Non
Allergies:
na
Maladie actuelle
na