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VAERS Report 2157208

Case Report Section

Vaer Report Details

Age: 52 years old

Gender: Female

State: Outside US

Patient Died?
No
Vaccine information

Name: COVID19 (COVID19 (MODERNA))

Type: Coronavirus 2019 vaccine

Manufacturer: MODERNA

Lot: 3002622sc5/12


Date report was received
2022-03-04
Date form completed
Date Vaccinated
2021-07-20
Date of Onset
0
Number of days (onset date – vaccination date)
0
Adverse Event Description

anticovid vaccination carried out on 20/07/2021. hyperpyrexia in the evening, at night it reached 39.6 c, at night i had convulsions. communicated to the doctor the day after which he tells me (continued); anticovid vaccination carried out on 20/07/2021. hyperpyrexia in the evening, at night it reached 39.6 c, at night i had convulsions. communicated to the doctor the day after which he tells me (continued); anticovid vaccination carried out on 20/07/2021. hyperpyrexia in the evening, at night it reached 39.6 c, at night i had convulsions. communicated to the doctor the day after which he tells me (continued); anticovid vaccination carried out on 20/07/2021. hyperpyrexia in the evening, at night it reached 39.6 c, at night i had convulsions. communicated to the doctor the day after which he tells me (continued); anticovid vaccination carried out on 20/07/2021. hyperpyrexia in the evening, at night it reached 39.6 c, at night i had convulsions. communicated to the doctor the day after which he tells me (continued); anticovid vaccination carried out on 20/07/2021. hyperpyrexia in the evening, at night it reached 39.6 c, at night i had convulsions. communicated to the doctor the day after which he tells me (continued); anticovid vaccination carried out on 20/07/2021. hyperpyrexia in the evening, at night it reached 39.6 c, at night i had convulsions. communicated to the doctor the day after which he tells me (continued); anticovid vaccination carried out on 20/07/2021. hyperpyrexia in the evening, at night it reached 39.6 c, at night i had convulsions. communicated to the doctor the day after which he tells me (continued); this case was received (reference number: it-minisal02-840480) 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 vaccination site oedema (anticovid vaccination carried out on 20/07/2021. hyperpyrexia in the evening, at night it reached 39.6 c, at night i had convulsions. communicated to the doctor the day after which he tells me (continued)), insomnia (anticovid vaccination carried out on 20/07/2021. hyperpyrexia in the evening, at night it reached 39.6 c, at night i had convulsions. communicated to the doctor the day after which he tells me (continued)), hyperpyrexia (anticovid vaccination carried out on 20/07/2021. hyperpyrexia in the evening, at night it reached 39.6 c, at night i had convulsions. communicated to the doctor the day after which he tells me (continued)), palpitations (anticovid vaccination carried out on 20/07/2021. hyperpyrexia in the evening, at night it reached 39.6 c, at night i had convulsions. communicated to the doctor the day after which he tells me (continued)), pain in extremity (anticovid vaccination carried out on 20/07/2021. hyperpyrexia in the evening, at night it reached 39.6 c, at night i had convulsions. communicated to the doctor the day after which he tells me (continued)), seizure (anticovid vaccination carried out on 20/07/2021. hyperpyrexia in the evening, at night it reached 39.6 c, at night i had convulsions. communicated to the doctor the day after which he tells me (continued)), eye irritation (anticovid vaccination carried out on 20/07/2021. hyperpyrexia in the evening, at night it reached 39.6 c, at night i had convulsions. communicated to the doctor the day after which he tells me (continued)) and fatigue (anticovid vaccination carried out on 20/07/2021. hyperpyrexia in the evening, at night it reached 39.6 c, at night i had convulsions. communicated to the doctor the day after which he tells me (continued)) in a 52-year-old female patient who received mrna-1273 (spikevax) (batch no. 3002622 sc 5/12/21) for covid-19 vaccination. no medical history information was reported. on 20-jul-2021, the patient received dose of mrna-1273 (spikevax) (intramuscular) 1 dosage form. on 20-jul-2021, the patient experienced vaccination site oedema (anticovid vaccination carried out on 20/07/2021. hyperpyrexia in the evening, at night it reached 39.6 c, at night i had convulsions. communicated to the doctor the day after which he tells me (continued)) (seriousness criterion medically significant), insomnia (anticovid vaccination carried out on 20/07/2021. hyperpyrexia in the evening, at night it reached 39.6 c, at night i had convulsions. communicated to the doctor the day after which he tells me (continued)) (seriousness criterion medically significant), hyperpyrexia (anticovid vaccination carried out on 20/07/2021. hyperpyrexia in the evening, at night it reached 39.6 c, at night i had convulsions. communicated to the doctor the day after which he tells me (continued)) (seriousness criterion medically significant), palpitations (anticovid vaccination carried out on 20/07/2021. hyperpyrexia in the evening, at night it reached 39.6 c, at night i had convulsions. communicated to the doctor the day after which he tells me (continued)) (seriousness criterion medically significant), pain in extremity (anticovid vaccination carried out on 20/07/2021. hyperpyrexia in the evening, at night it reached 39.6 c, at night i had convulsions. communicated to the doctor the day after which he tells me (continued)) (seriousness criterion medically significant), seizure (anticovid vaccination carried out on 20/07/2021. hyperpyrexia in the evening, at night it reached 39.6 c, at night i had convulsions. communicated to the doctor the day after which he tells me (continued)) (seriousness criterion medically significant), eye irritation (anticovid vaccination carried out on 20/07/2021. hyperpyrexia in the evening, at night it reached 39.6 c, at night i had convulsions. communicated to the doctor the day after which he tells me (continued)) (seriousness criterion medically significant) and fatigue (anticovid vaccination carried out on 20/07/2021. hyperpyrexia in the evening, at night it reached 39.6 c, at night i had convulsions. communicated to the doctor the day after which he tells me (continued)) (seriousness criterion medically significant). at the time of the report, vaccination site oedema (anticovid vaccination carried out on 20/07/2021. hyperpyrexia in the evening, at night it reached 39.6 c, at night i had convulsions. communicated to the doctor the day after which he tells me (continued)), insomnia (anticovid vaccination carried out on 20/07/2021. hyperpyrexia in the evening, at night it reached 39.6 c, at night i had convulsions. communicated to the doctor the day after which he tells me (continued)), hyperpyrexia (anticovid vaccination carried out on 20/07/2021. hyperpyrexia in the evening, at night it reached 39.6 c, at night i had convulsions. communicated to the doctor the day after which he tells me (continued)), palpitations (anticovid vaccination carried out on 20/07/2021. hyperpyrexia in the evening, at night it reached 39.6 c, at night i had convulsions. communicated to the doctor the day after which he tells me (continued)), pain in extremity (anticovid vaccination carried out on 20/07/2021. hyperpyrexia in the evening, at night it reached 39.6 c, at night i had convulsions. communicated to the doctor the day after which he tells me (continued)), seizure (anticovid vaccination carried out on 20/07/2021. hyperpyrexia in the evening, at night it reached 39.6 c, at night i had convulsions. communicated to the doctor the day after which he tells me (continued)), eye irritation (anticovid vaccination carried out on 20/07/2021. hyperpyrexia in the evening, at night it reached 39.6 c, at night i had convulsions. communicated to the doctor the day after which he tells me (continued)) and fatigue (anticovid vaccination carried out on 20/07/2021. hyperpyrexia in the evening, at night it reached 39.6 c, at night i had convulsions. communicated to the doctor the day after which he tells me (continued)) had not resolved. the action taken with mrna-1273 (spikevax) (intramuscular) was unknown. no concomitant medications were reported modern vaccine n dose (2) taken on 20/07/2031 at 9:11 am batch 3003655 expiry 31/12/2021, im left arm. no treatment medications were reported. company comment: this is a regulatory case concerning a 52-years-old female patient with no significant clinical history who experienced the unexpected events of seizure (aesi), vaccination site oedema, insomnia, hyperpyrexia, palpitations, pain in extremity, eye irritation and fatigue 1 days after a dose of rna-1273. the benefit-risk relationship of mrna-1273 vaccine is not affected by this report. terms and onset were captured as provided. the case was assessed as serious by the regulatory authority�s report due to ime; reporter's comments: adr received by e-mail to the cesena pv manager on 5/2/22 from , with only the description of the adr, without a completed form. modern vaccine n. dose (2) taken on 20/07/2031 at 9:11 am batch 3003655 expiry 31/12/2021, im left arm.; sender's comments: company comment: this is a regulatory case concerning a 52-years-old female patient with no significant clinical history who experienced the unexpected events of seizure (aesi), vaccination site oedema, insomnia, hyperpyrexia, palpitations, pain in extremity, eye irritation and fatigue 1 days after a dose of rna-1273. the benefit-risk relationship of mrna-1273 vaccine is not affected by this report. terms and onset were captured as provided. the case was assessed as serious by the regulatory authority�s report due to ime

Lab Data
na
List of symptoms
fatigue pain in extremity insomnia palpitations eye irritation seizure vaccination site oedema hyperpyrexia
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?
No
Allergies:
na
Current Illness
na