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VAERS Report 2136766

Case Report Section

Détails du rapport Vaer

Âge: N/A

Genre: Male

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
2022-01-06
Date d’apparition
0
Nombre de jours (date d’apparition – date de vaccination)
0
Description de l’événement indésirable

this case was received via ra (reference number: nl-lrb-00782916) on 16-feb-2022 and was forwarded to moderna on 16-feb-2022. this regulatory authority case was reported by a consumer and describes the occurrence of myocardial infarction in an elderly male patient who received mrna-1273 (spikevax) for covid-19 vaccination. previously administered products included for product used for unknown indication: pfizer biontech covid-19 vaccine (biontech/pfizer vaccin (comirnaty) covid-19 vaccin pfizer injvlst 0,3ml) on 07-may-2021, pfizer biontech covid-19 vaccine (biontech/pfizer vaccin (comirnaty) covid-19 vaccin pfizer injvlst 0,3mlcovid-19 vaccin pfizer injvlst) on 11-jun-2021, pfizer biontech covid-19 vaccine (biontech/pfizer vaccin (comirnaty) covid-19 vaccin pfizer injvlst 0 and3mlcovid-19 vaccin pfizer injvlst) on 11-jun-2021. past adverse reactions to the above products included deep vein thrombosis with pfizer biontech covid-19 vaccine; no adverse event with pfizer biontech covid-19 vaccine; and pulmonary embolism with pfizer biontech covid-19 vaccine. on 06-jan-2022, the patient received dose of mrna-1273 (spikevax) (unknown route) 1 dosage form. on an unknown date, the patient experienced myocardial infarction (seriousness criterion life threatening). at the time of the report, myocardial infarction outcome was unknown. no concomitant medication was reported no treatment medication was reported company comment: this is a regulatory authority case concerning an elderly male patient, with medical history of deep vein thrombosis after pfizer vaccine, who experienced the unexpected, serious (life threatening), and aesi of myocardial infarction. the event occurred on an unknown date after the third dose of mrna-1273 vaccine. patient completed primary vaccination against covid-19 with pfizer vaccine (interchange of vaccine products). medical history and interchange of vaccine products, remain confounders. the benefit-risk relationship of mrna-1273 vaccine is not affected by this report.; sender's comments: this is a regulatory authority case concerning an elderly male patient, with medical history of deep vein thrombosis after pfizer vaccine, who experienced the unexpected, serious (life threatening), and aesi of myocardial infarction. the event occurred on an unknown date after the third dose of mrna-1273 vaccine. patient completed primary vaccination against covid-19 with pfizer vaccine (interchange of vaccine products). medical history and interchange of vaccine products, remain confounders. the benefit-risk relationship of mrna-1273 vaccine is not affected by this report

Données de laboratoire
na
Liste des symptômes
myocardial infarction
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?
Non
Séjour à l’hôpital
Non
Nombre de jours à l’hôpital
Non spécifié
Invalidité permanente?
Non
Allergies:
na
Maladie actuelle
na