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VAERS Report 2136768

Case Report Section

Vaer Report Details

Age: 78 years old

Gender: Female

State: Outside US

Patient Died?
No
Vaccine information

Name: COVID19 (COVID19 (MODERNA))

Type: Coronavirus 2019 vaccine

Manufacturer: MODERNA

Lot: 094f21a


Date report was received
2022-02-24
Date form completed
Date Vaccinated
2021-12-16
Date of Onset
5
Number of days (onset date – vaccination date)
5
Adverse Event Description

herseninfarct; this regulatory authority case was reported by a consumer and describes the occurrence of ischaemic cerebral infarction (herseninfarct) in a 78-year-old female patient who received mrna-1273 (spikevax) (batch no. 094f21a) for covid-19 vaccination. previously administered products included for product used for unknown indication: biontech/pfizer vaccin (comirnaty) covid-19 vaccin pfizer injvlst 0,3ml on 19-mar-2021, biontech/pfizer vaccin (comirnaty) covid-19 vaccin pfizer injvlst 0 and3ml on 19-apr-2021. past adverse reactions to the above products included no adverse reaction with biontech/pfizer vaccin (comirnaty) covid-19 vaccin pfizer injvlst 0,3ml, biontech/pfizer vaccin (comirnaty) covid-19 vaccin pfizer injvlst 0 and3ml. on 16-dec-2021, the patient received dose of mrna-1273 (spikevax) (unknown route) 1 dosage form. on 21-dec-2021, the patient experienced ischaemic cerebral infarction (herseninfarct) (seriousness criterion hospitalization). at the time of the report, ischaemic cerebral infarction (herseninfarct) was resolving. no concomitant medication was provided. no treatment medication was provided. company comment: this regulatory case concerns a 78-year-old female patient no reported medical history, who experienced the unexpected serious aesi event of ischaemic cerebral infarction 6 days following the receipt of mrna-1273 vaccine. the patient had previously received 2 doses of comirnaty (interchange of vaccine products). elderly age of the patient can be a risk factors for the event. the benefit-risk relationship of mrna-1273 is not affected by this report. seriousness of the event retained as per regulatory authority reporting.; sender's comments: this regulatory case concerns a 78-year-old female patient no reported medical history, who experienced the unexpected serious aesi event of ischaemic cerebral infarction 6 days following the receipt of mrna-1273 vaccine. the patient had previously received 2 doses of comirnaty (interchange of vaccine products). elderly age of the patient can be a risk factors for the event. the benefit-risk relationship of mrna-1273 is not affected by this report. seriousness of the event retained as per regulatory authority reporting

Lab Data
na
List of symptoms
ischaemic cerebral infarction
Patient Died?
No
Date Died
NA
Birth defect
false
Vaccine Administered By:
Unknown
Vaccine Purchased By:
Unknown
Patient visit ER?
No
Patient Hospitalized?
Yes
Stay in hospital
No
Days in hospital
Unspecified
Permanent disability?
No
Allergies:
na
Current Illness
na