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VAERS Report 2157201

Case Report Section

Vaer Report Details

Age: 52 years old

Gender: Male

State: Outside US

Patient Died?
No
Vaccine information

Name: COVID19 (COVID19 (MODERNA))

Type: Coronavirus 2019 vaccine

Manufacturer: MODERNA

Lot: 214064


Date report was received
2022-03-04
Date form completed
Date Vaccinated
2022-01-15
Date of Onset
16
Number of days (onset date – vaccination date)
16
Adverse Event Description

oppression/weight on the heart shortness paresis slight right eye; oppression/weight on the heart shortness paresis slight right eye; oppression/weight on the heart shortness paresis slight right eye; this case was received via agency (reference number: it-minisal02-840189) on 23-feb-2022 and was forwarded to moderna on 23-feb-2022. this regulatory authority case was reported by a consumer and describes the occurrence of dyspnoea (oppression/weight on the heart shortness paresis slight right eye), ophthalmoplegia (oppression/weight on the heart shortness paresis slight right eye) and cardiac discomfort (oppression/weight on the heart shortness paresis slight right eye) in a 52-year-old male patient who received mrna-1273 (spikevax) (batch no. 214064) for covid-19 vaccination. concurrent conditions included autoimmune hypothyroidism. concomitant products included levothyroxine sodium (eutirox) for an unknown indication. on 15-jan-2022, the patient received dose of mrna-1273 (spikevax) (intramuscular) 1 dosage form. on 31-jan-2022, the patient experienced dyspnoea (oppression/weight on the heart shortness paresis slight right eye) (seriousness criterion hospitalization), ophthalmoplegia (oppression/weight on the heart shortness paresis slight right eye) (seriousness criterion hospitalization) and cardiac discomfort (oppression/weight on the heart shortness paresis slight right eye) (seriousness criterion hospitalization). at the time of the report, dyspnoea (oppression/weight on the heart shortness paresis slight right eye), ophthalmoplegia (oppression/weight on the heart shortness paresis slight right eye) and cardiac discomfort (oppression/weight on the heart shortness paresis slight right eye) had not resolved. the action taken with mrna-1273 (spikevax) (intramuscular) was unknown. no treatment details were reported. company comment : this regulatory authority case concerns a 52 -years-old, male patient with relevant medical history of autoimmune hypothyroidism reported, who experienced unexpected serious events of dyspnoea, ophthalmoplegia, cardiac discomfort (seriousness criterion hospitalization), which occurred 16 days after a dose of (dose number not specified) of mrna-1273 vaccine administration. medical history of autoimmune hypothyroidism remains as confounding. 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.; reporter's comments: autoimmune hypothyroidism.; sender's comments: this regulatory authority case concerns a 52 -years-old, male patient with relevant medical history of autoimmune hypothyroidism reported, who experienced unexpected serious events of dyspnoea, ophthalmoplegia, cardiac discomfort (seriousness criterion hospitalization), which occurred 16 days after a dose of (dose number not specified) of mrna-1273 vaccine administration. medical history of autoimmune hypothyroidism remains as confounding. 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

Lab Data
na
List of symptoms
dyspnoea ophthalmoplegia cardiac discomfort
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