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VAERS Report 2156920

Case Report Section

Vaer Report Details

Age: NA

Gender: Female

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
2022-01-25
Date of Onset
0
Number of days (onset date – vaccination date)
0
Adverse Event Description

fever; joint ache; chills; headache; this case was received via regulatory authority. this regulatory authority case was reported by a consumer and describes the occurrence of pyrexia (fever), arthralgia (joint ache), chills (chills) and headache (headache) in a female patient of an unknown age who received mrna-1273 (moderna covid-19 vaccine) for an unknown indication. no medical history information was reported. on 25-jan-2022, the patient received third dose of mrna-1273 (moderna covid-19 vaccine) (unknown route) 1 dosage form. on 25-jan-2022, the patient experienced pyrexia (fever) (seriousness criterion medically significant), arthralgia (joint ache) (seriousness criterion medically significant), chills (chills) (seriousness criterion medically significant) and headache (headache) (seriousness criterion medically significant). on 27-jan-2022, pyrexia (fever) had resolved. on 29-jan-2022, chills (chills) had resolved. at the time of the report, arthralgia (joint ache) and headache (headache) had not resolved. 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. concomitant product use was not provided by the reporter. on 25-jan-2022, the patient received dose 3a of mrna-1273 (spikevax). patient received moderna 3rd shot/booster on the aforementioned date and experienced headaches almost everyday since then. patient has not tested positive for covid-19 since having the vaccine. patient was not enrolled in clinical trial. report not related to possible inflammation of the heart (myocarditis or pericarditis). treatment information was not provided. company comment: this is a regulatory case concerning a female patient of unknown age with no medical history reported who experienced the serious (medically significant) and unexpected events of pyrexia, arthralgia, headache and chills the same day a dose of mrna-1273 vaccine, given as a booster dose, was administered. patient reported she experienced headaches almost every day since vaccination. no further details were provided for medical reviewing. the benefit-risk relationship of the mrna-1273 vaccine is not affected by this report. event seriousness was captured as reported.; sender's comments: this is a regulatory case concerning a female patient of unknown age with no medical history reported who experienced the serious (medically significant) and unexpected events of pyrexia, arthralgia, headache and chills the same day a dose of mrna-1273 vaccine, given as a booster dose, was administered. patient reported she experienced headaches almost every day since vaccination. no further details were provided for medical reviewing. the benefit-risk relationship of the mrna-1273 vaccine is not affected by this report. event seriousness was captured as reported

Lab Data
test name: covid-19 virus test; test result: negative ; result unstructured data: no - negative covid-19 test
List of symptoms
chills headache arthralgia pyrexia sars-cov-2 test
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