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VAERS Report 2136769

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
2022-01-02
Date d’apparition
0
Nombre de jours (date d’apparition – date de vaccination)
0
Description de l’événement indésirable

longembolie booster; this regulatory authority case was reported by a consumer and describes the occurrence of pulmonary embolism (longembolie booster) 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 on 14-apr-2021 and pfizer biontech covid-19 vaccine on 19-may-2021. past adverse reactions to the above products included deep vein thrombosis leg with pfizer biontech covid-19 vaccine; and no adverse reaction with pfizer biontech covid-19 vaccine. concomitant products included rivaroxaban (xarelto) for an unknown indication. on 02-jan-2022, the patient received dose of mrna-1273 (spikevax) (unknown route) 1 dosage form. on an unknown date, the patient experienced pulmonary embolism (longembolie booster) (seriousness criterion life threatening). at the time of the report, pulmonary embolism (longembolie booster) was resolving. no treatment details were provided. company comment : this regulatory authority case concerns of unknown age, male patient with no medical history reported, who experienced the unexpected serious aesi event of pulmonary embolism (serious criteria life threating), which occurred on unknown date after a dose (dose number not specified) of mrna-1273 vaccine administration. the patient was noted to have received first two doses with comirnaty 7 months prior to current vaccination with mrna-1273 (interchange of vaccine products). at the time of report event outcome was resolving. the benefit-risk relationship of mrna-1273 is not affected by this report. the events were assessed as serious as per regulatory authority�s report.; sender's comments: this regulatory authority case concerns of unknown age, male patient with no medical history reported, who experienced the unexpected serious aesi event of pulmonary embolism (serious criteria life threating), which occurred on unknown date after a dose (dose number not specified) of mrna-1273 vaccine administration. the patient was noted to have received first two doses with comirnaty 7 months prior to current vaccination with mrna-1273 (interchange of vaccine products). at the time of report event outcome was resolving. the benefit-risk relationship of mrna-1273 is not affected by this report. the events were assessed as serious as per regulatory authority�s report

Données de laboratoire
na
Liste des symptômes
pulmonary embolism
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