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VAERS Report 2156953

Case Report Section

Vaer Report Details

Age: 52 years old

Gender: Female

State: Outside US

Patient Died?
No
Vaccine information

Name: COVID19 (COVID19 (MODERNA))

Type: Coronavirus 2019 vaccine

Manufacturer: MODERNA

Lot: unknown


Name: COVID19 (COVID19 (UNKNOWN))

Type: Coronavirus 2019 vaccine

Manufacturer: UNKNOWN

Lot: pv46673


Date report was received
2022-03-04
Date form completed
Date Vaccinated
2021-03-24
Date of Onset
0
Number of days (onset date – vaccination date)
0
Adverse Event Description

muscle spasm; headache occurring; this case was received via the regulatory authority ra (reference number: gb-mhra-adr 25014906) 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 occurring) and muscle spasms (muscle spasm) in a 52-year-old female patient who received mrna-1273 (moderna covid-19 vaccine) for an unknown indication. co-suspect product included non-company product covid-19 vaccine nrvv ad (chadox1 ncov-19) (covid-19 vaccine astrazeneca) for covid-19 vaccination. no medical history information was reported. on 24-mar-2021, the patient received dose of covid-19 vaccine nrvv ad (chadox1 ncov-19) (covid-19 vaccine astrazeneca) (unknown route) 1 dosage form. on 24-nov-2021, the patient received third dose of mrna-1273 (moderna covid-19 vaccine) (unknown route) 1 dosage form. on 24-mar-2021, after starting mrna-1273 (moderna covid-19 vaccine), the patient experienced headache (headache occurring) (seriousness criterion medically significant). on 25-mar-2021, the patient experienced muscle spasms (muscle spasm) (seriousness criterion medically significant). on 26-mar-2021, muscle spasms (muscle spasm) had resolved. at the time of the report, headache (headache occurring) had not resolved. the action taken with mrna-1273 (moderna covid-19 vaccine) (unknown) was unknown. concomitant medication use information was not provided by reporter. patient has not had symptoms associated with covid-19 and not had a covid-19 test. patient was not currently breastfeeding. patient had not tested positive for covid-19 since having the vaccine. patient was not enrolled in clinical trial. the dosage text for suspect drug was reported as dose 3b. treatment medication use information was not provided by reporter. company comment: this regulatory authority case concerns a 52-year-old female patient with medical history (not reported), who experienced the serious unexpected event of headache, and muscle spasms. the events occurred before the dose of mrna-1273, moderna covid-19 vaccine. how ever patient received dose of covid-19 vaccine nrvv ad (chadox1 ncov-19) (covid-19 vaccine astrazeneca) and events occurred on the same day. the benefit-risk relationship f mrna-1273, moderna covid-19 vaccine is not affected by this report.; sender's comments: this regulatory authority case concerns a 52-year-old female patient with medical history (not reported), who experienced the serious unexpected event of headache, and muscle spasms. the events occurred before the dose of mrna-1273, moderna covid-19 vaccine. how ever patient received dose of covid-19 vaccine nrvv ad (chadox1 ncov-19) (covid-19 vaccine astrazeneca) and events occurred on the same day. the benefit-risk relationship f mrna-1273, moderna covid-19 vaccine is not affected by this report

Lab Data
na
List of symptoms
headache muscle spasms
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