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VAERS Report 2156921

Case Report Section

Vaer Report Details

Age: 41 years old

Gender: Male

State: Outside US

Patient Died?
No
Vaccine information

Name: COVID19 (COVID19 (MODERNA))

Type: Coronavirus 2019 vaccine

Manufacturer: MODERNA

Lot: 3005688


Date report was received
2022-03-04
Date form completed
Date Vaccinated
2021-12-19
Date of Onset
5
Number of days (onset date – vaccination date)
5
Adverse Event Description

shoulder pain; altered sensation; sars-cov-2 infection; frozen shoulder exacerbated; this case was received via the regulatory authority ra (reference number: gb-mhra-adr 26655725) 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 arthralgia (shoulder pain), paraesthesia (altered sensation), covid-19 (sars-cov-2 infection) and periarthritis (frozen shoulder exacerbated) in a 41-year-old male patient who received mrna-1273 (moderna covid-19 vaccine) (batch no. 3005688) for an unknown indication. concomitant products included cortisone, covid-19 vaccine nrvv ad (chadox1 ncov-19) (covid-19 vaccine astrazeneca) from 15-mar-2021 to an unknown date and covid-19 vaccine nrvv ad (chadox1 ncov-19) (covid-19 vaccine astrazeneca) for an unknown indication. on 19-dec-2021, the patient received third dose of mrna-1273 (moderna covid-19 vaccine) (unknown route) 1 dosage form. on 24-dec-2021, the patient experienced periarthritis (frozen shoulder exacerbated) (seriousness criterion disability). on 29-dec-2021, the patient experienced covid-19 (sars-cov-2 infection) (seriousness criterion disability). on an unknown date, the patient experienced arthralgia (shoulder pain) (seriousness criterion disability) and paraesthesia (altered sensation) (seriousness criterion disability). on 03-jan-2022, covid-19 (sars-cov-2 infection) had resolved. at the time of the report, arthralgia (shoulder pain) and paraesthesia (altered sensation) was resolving and periarthritis (frozen shoulder exacerbated) had not resolved. diagnostic results (normal ranges are provided in parenthesis if available): on 28-dec-2021, sars-cov-2 test: yes - positive covid-19 test yes - positive covid-19 test. the action taken with mrna-1273 (moderna covid-19 vaccine) (unknown) was unknown. event started with acute shoulder pain on 24th dec which continued to get worse, swelling and spasm followed with pain through the shoulder blade down to the hand. this was followed by altered sensation and subsequent power loss to the shoulder and upper arm. repeated doctors appointments with significant medication prescribed which was largely ineffective. cortisone injection into the shoulder joint on 10/01/2022 which was also ineffective. this resulted in being off work for 5 weeks and was still a significant unresolved problem. patient was not enrolled in clinical trial. this report was not related to possible inflammation of the heart (myocarditis or pericarditis). details of any relevant investigations or tests conducted: mri scan on 01/02/2022. company comment: this is a regulatory authority case concerning a 41-year-old male patient, with no medical history reported, who experienced the unexpected and serious (disability) events of arthralgia, paraesthesia, covid-19 (adr), and periarthritis (adr). the events occurred between 5 and 10 days after the third dose of mrna-1273 vaccine. primary vaccination against covid-19 completed with astrazeneca vaccine (interchange of vaccine products). patient reports having received cortisone injection into shoulder joint, which was ineffective; this resulted in being off work for 5 weeks, and is still a significant unresolved problem. an mri scan was performed, with unknown result. sars-cov-2 test positive. the benefit-risk relationship of mrna-1273 vaccine is not affected by this report.; sender's comments: this is a regulatory authority case concerning a 41-year-old male patient, with no medical history reported, who experienced the unexpected and serious (disability) events of arthralgia, paraesthesia, covid-19 (adr), and periarthritis (adr). the events occurred between 5 and 10 days after the third dose of mrna-1273 vaccine. primary vaccination against covid-19 completed with astrazeneca vaccine (interchange of vaccine products). patient reports having received cortisone injection into shoulder joint, which was ineffective; this resulted in being off work for 5 weeks, and is still a significant unresolved problem. an mri scan was performed, with unknown result. sars-cov-2 test positive. the benefit-risk relationship of mrna-1273 vaccine is not affected by this report

Lab Data
test date: 20211228; test name: covid-19 virus test; result unstructured data: yes - positive covid-19 test
List of symptoms
paraesthesia arthralgia periarthritis covid-19 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?
Yes
Allergies:
na
Current Illness
na