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VAERS Report 2157041

Case Report Section

Vaer Report Details

Age: 42 years old

Gender: Male

State: Outside US

Patient Died?
No
Vaccine information

Name: COVID19 (COVID19 (MODERNA))

Type: Coronavirus 2019 vaccine

Manufacturer: MODERNA

Lot: unknown


Date report was received
2022-03-04
Date form completed
Date Vaccinated
Date of Onset
0
Number of days (onset date – vaccination date)
0
Adverse Event Description

exhaustion; lymph nodes cervical swollen; this case was received via regulatory authority (reference number: gr-greof-20217507) on 01-mar-2022 and was forwarded to moderna on 01-mar-2022. this regulatory authority case was reported by a consumer and describes the occurrence of lymphadenopathy (lymph nodes cervical swollen) in a 42-year-old male patient who received mrna-1273 (spikevax) for covid-19 vaccination. the occurrence of additional non-serious events is detailed below. no medical history information was reported. on an unknown date, the patient received dose of mrna-1273 (spikevax) (intramuscular) 1 dosage form. on 01-sep-2021, the patient experienced fatigue (exhaustion) and lymphadenopathy (lymph nodes cervical swollen) (seriousness criterion disability). at the time of the report, fatigue (exhaustion) and lymphadenopathy (lymph nodes cervical swollen) had not resolved. the action taken with mrna-1273 (spikevax) (intramuscular) was unknown. no concomitant drug details were reported. no treatment details were reported. company comment: this regulatory case concerns a 42-year-old, male patient with no medical history reported, who experienced the unexpected, serious (seriousness criteria disability) event of lymphadenopathy an unknown duration after the unknown dose of mrna-1273. no relevant lab data or details regarding clinical course and treatment received were reported. at the time of report, outcome of the event was not resolved. the benefit-risk relationship of mrna-1273 vaccine is not affected by this report. event seriousness assessed as per regulatory authority reporting, however there was no information in the source document supporting that the events resulted in a persistent or permanent incapacity.; sender's comments: this regulatory case concerns a 42-year-old, male patient with no medical history reported, who experienced the unexpected, serious (seriousness criteria disability) event of lymphadenopathy an unknown duration after the unknown dose of mrna-1273. no relevant lab data or details regarding clinical course and treatment received were reported. at the time of report, outcome of the event was not resolved. the benefit-risk relationship of mrna-1273 vaccine is not affected by this report. event seriousness assessed as per regulatory authority reporting, however there was no information in the source document supporting that the events resulted in a persistent or permanent incapacity

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