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VAERS Report 2156922

Case Report Section

Vaer Report Details

Age: 70 years old

Gender: Male

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
2022-02-25
Date of Onset
0
Number of days (onset date – vaccination date)
0
Adverse Event Description

headache fullness; this case was received via the regulatory authority ra (reference number: gb-mhra-adr 26655747) 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 headache (headache fullness) in a 70-year-old male patient who received mrna-1273 (moderna covid-19 vaccine) for an unknown indication. concurrent medical conditions included rheumatoid arthritis (taking regular medicines for rheumatoid arthritis (or other types of arthritis except osteoarthr...). on 25-feb-2022, the patient received dose of mrna-1273 (moderna covid-19 vaccine) (unknown route) 1 dosage form. on 25-feb-2022, the patient experienced headache (headache fullness) (seriousness criterion medically significant). at the time of the report, headache (headache fullness) had not resolved. the action taken with mrna-1273 (moderna covid-19 vaccine) (unknown) was unknown. no concomitant medication was reported. no treatment medication was reported. patient did not had symptoms associated with covid-19 nor had a covid-19 test. dosage text was reported as dose 4c. patient had very bad headache and shiffering flu like symptoms. patient was not tested positive for covid-19 since having the vaccine. patient was not enrolled in clinical trial. the report did not relate to possible inflammation of the heart (myocarditis or pericarditis). company comment: this regulatory authority case concerns a 70-year-old male patient with medical history (rheumatoid arthritis), who experienced the serious unexpected event of headache. the event started occurring approximately within (1 day) after the dose of mrna-1273, moderna covid-19 vaccine. the benefit-risk relationship of mrna-1273, moderna covid-19 vaccine is not affected by this report.; sender's comments: this regulatory authority case concerns a 70-year-old male patient with medical history (rheumatoid arthritis), who experienced the serious unexpected event of headache. the event started occurring approximately within (1 day) after the dose of mrna-1273, moderna covid-19 vaccine. the benefit-risk relationship of mrna-1273, moderna covid-19 vaccine is not affected by this report

Lab Data
na
List of symptoms
headache
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
rheumatoid arthritis (taking regular medicines for rheumatoid arthritis (or other types of arthritis except osteoarthr...)