Page breadcrumb nav

VAERS Report 2156895

Case Report Section

Vaer Report Details

Age: 33 years old

Gender: Female

State: Outside US

Patient Died?
Vaccine information


Type: Coronavirus 2019 vaccine

Manufacturer: MODERNA

Lot: 3005889

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

tiredness; fever; red rash; this case was received via the regulatory authority ra (reference number: gb-mhra-adr 26646054) on 27-feb-2022 and was forwarded to moderna on 27-feb-2022. this regulatory authority case was reported by a consumer and describes the occurrence of fatigue (tiredness), pyrexia (fever) and rash erythematous (red rash) in a 33-year-old female patient who received mrna-1273 (moderna covid-19 vaccine) (batch no. 3005889) for an unknown indication. no medical history information was reported. on 07-jan-2022, the patient received third dose of mrna-1273 (moderna covid-19 vaccine) (unknown route) 1 dosage form. on 08-jan-2022, the patient experienced pyrexia (fever) (seriousness criterion medically significant) and rash erythematous (red rash) (seriousness criterion medically significant). on an unknown date, the patient experienced fatigue (tiredness) (seriousness criterion medically significant). on 09-jan-2022, pyrexia (fever) had resolved. on 11-jan-2022, rash erythematous (red rash) had resolved. at the time of the report, fatigue (tiredness) was resolving. diagnostic results (normal ranges are provided in parenthesis if available): on an unknown date, sars-cov-2 test: no - negative covid-19 test (negative) no - negative covid-19 test. the action taken with mrna-1273 (moderna covid-19 vaccine) (unknown) was unknown. no concomitant medications were reported. immediately following the vaccination patient felt the usual tiredness and sore arm. approximately 30 hours after vaccination, the tiredness was severe and patient was started to feel very head-achey and overheated whilst also being shivery. temperature reading was over 38. patient took paracetamol and ibuprofen to deal with this which seemed to help. approx. 36 hours after vaccination the skin on patient lower torso appeared blotchy, by the morning her entire abdomen, chest and neck were covered in a red rash. it was also beginning to spread up her back and down the tops of her legs and pelvic area. rash was not raised or itchy but bright red. this took approximately 3 days to disappear completely. patient has not tested positive for covid-19 since having the vaccine. patient has not had symptoms associated with covid-19. patient is not pregnant, patient is not currently breastfeeding. patient is not enrolled in clinical trial. patient report did not relate to possible inflammation of the heart (myocarditis or pericarditis)

Lab Data
test name: covid-19 virus test; test result: negative ; result unstructured data: no - negative covid-19 test
List of symptoms
fatigue rash erythematous pyrexia sars-cov-2 test
Patient Died?
Date Died
Birth defect
Vaccine Administered By:
Vaccine Purchased By:
Patient visit ER?
Patient Hospitalized?
Stay in hospital
Days in hospital
Permanent disability?
Current Illness