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VAERS Report 2156904

Case Report Section

Vaer Report Details

Age: 38 years old

Gender: Male

State: Outside US

Patient Died?
No
Vaccine information

Name: COVID19 (COVID19 (MODERNA))

Type: Coronavirus 2019 vaccine

Manufacturer: MODERNA

Lot: 5914


Date report was received
2022-03-04
Date form completed
Date Vaccinated
2022-02-23
Date of Onset
0
Number of days (onset date – vaccination date)
0
Adverse Event Description

fatigue/unusual tiredness; fever; shortness of breath; heart palpitations; breathlessness; fever; this case was received via regulatory authority (reference number: gb-ra-adr 26649170) 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 dyspnoea (breathlessness), the first episode of pyrexia (fever), fatigue (fatigue/unusual tiredness), the second episode of pyrexia (fever), dyspnoea (shortness of breath) and palpitations (heart palpitations) in a 38-year-old male patient who received mrna-1273 (moderna covid-19 vaccine) (batch no. 5914) for an unknown indication. concomitant products included tozinameran (covid-19 mrna vaccine bnt162b2) and finasteride from 01-jan-2021 to an unknown date for an unknown indication. on 23-feb-2022, the patient received third dose of mrna-1273 (moderna covid-19 vaccine) (unknown route) 1 dosage form. on 23-feb-2022, the patient experienced the first episode of pyrexia (fever) (seriousness criterion medically significant). on 24-feb-2022, the patient experienced dyspnoea (breathlessness) (seriousness criterion medically significant). on an unknown date, the patient experienced fatigue (fatigue/unusual tiredness) (seriousness criterion medically significant), the second episode of pyrexia (fever) (seriousness criterion medically significant), dyspnoea (shortness of breath) (seriousness criterion medically significant) and palpitations (heart palpitations) (seriousness criterion medically significant). at the time of the report, dyspnoea (breathlessness) had not resolved and fatigue (fatigue/unusual tiredness), the last episode of pyrexia (fever), dyspnoea (shortness of breath) and palpitations (heart palpitations) outcome was unknown. the action taken with mrna-1273 (moderna covid-19 vaccine) (unknown) was unknown. the patient was unsure if patient had symptoms associated with covid-19 not had a covid-19 test. no treatment medication was reported. the patient had not tested positive for covid-19 since having the vaccine. the patient was not enrolled in clinical trial. the report relates to possible inflammation of the heart (myocarditis or pericarditis). the symptoms did not lead to hospital stay and the diagnosis was not made by medical professional. the blood tests, such as for certain proteins (called troponin) that signal heart muscle damage were not taken. company comment: this regulatory authority case concerns a 38-yaer-old male patient, with no medical history reported, who experienced the serious (medically significant) unexpected events of dyspnoea, pyrexia and palpitations. the events of dyspnoea and pyrexia occurred within the first day after receiving a dose of mrna-1273, while no onset date was provided for palpitations. patient's previous vaccination schedule included 2 doses of tozinameran. it is reported that this case relates to possible inflammation of the heart (myocarditis or pericarditis); however, no diagnosis was medically confirmed and no blood tests tests that signal heart muscle damage were taken. the benefit-risk relationship of mrna-1273 is not affected by this report.; sender's comments: this regulatory authority case concerns a 38-yaer-old male patient, with no medical history reported, who experienced the serious (medically significant) unexpected events of dyspnoea, pyrexia and palpitations. the events of dyspnoea and pyrexia occurred within the first day after receiving a dose of mrna-1273, while no onset date was provided for palpitations. patient's previous vaccination schedule included 2 doses of tozinameran. it is reported that this case relates to possible inflammation of the heart (myocarditis or pericarditis); however, no diagnosis was medically confirmed and no blood tests tests that signal heart muscle damage were taken. the benefit-risk relationship of mrna-1273 is not affected by this report

Lab Data
na
List of symptoms
fatigue dyspnoea palpitations pyrexia
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