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VAERS Report 2157201

Case Report Section

Détails du rapport Vaer

Âge: 52 ans

Genre: Male

Région : Outside US

Patient décédé?
Non
Renseignements sur les vaccins

Nom: COVID19 (COVID19 (MODERNA))

Type : Coronavirus 2019 vaccine

Fabricant: MODERNA

Lot: 214064


Date de réception du rapport
2022-03-04
Date à laquelle le formulaire est complèté
Date de vaccination
2022-01-15
Date d’apparition
16
Nombre de jours (date d’apparition – date de vaccination)
16
Description de l’événement indésirable

oppression/weight on the heart shortness paresis slight right eye; oppression/weight on the heart shortness paresis slight right eye; oppression/weight on the heart shortness paresis slight right eye; this case was received via agency (reference number: it-minisal02-840189) on 23-feb-2022 and was forwarded to moderna on 23-feb-2022. this regulatory authority case was reported by a consumer and describes the occurrence of dyspnoea (oppression/weight on the heart shortness paresis slight right eye), ophthalmoplegia (oppression/weight on the heart shortness paresis slight right eye) and cardiac discomfort (oppression/weight on the heart shortness paresis slight right eye) in a 52-year-old male patient who received mrna-1273 (spikevax) (batch no. 214064) for covid-19 vaccination. concurrent conditions included autoimmune hypothyroidism. concomitant products included levothyroxine sodium (eutirox) for an unknown indication. on 15-jan-2022, the patient received dose of mrna-1273 (spikevax) (intramuscular) 1 dosage form. on 31-jan-2022, the patient experienced dyspnoea (oppression/weight on the heart shortness paresis slight right eye) (seriousness criterion hospitalization), ophthalmoplegia (oppression/weight on the heart shortness paresis slight right eye) (seriousness criterion hospitalization) and cardiac discomfort (oppression/weight on the heart shortness paresis slight right eye) (seriousness criterion hospitalization). at the time of the report, dyspnoea (oppression/weight on the heart shortness paresis slight right eye), ophthalmoplegia (oppression/weight on the heart shortness paresis slight right eye) and cardiac discomfort (oppression/weight on the heart shortness paresis slight right eye) had not resolved. the action taken with mrna-1273 (spikevax) (intramuscular) was unknown. no treatment details were reported. company comment : this regulatory authority case concerns a 52 -years-old, male patient with relevant medical history of autoimmune hypothyroidism reported, who experienced unexpected serious events of dyspnoea, ophthalmoplegia, cardiac discomfort (seriousness criterion hospitalization), which occurred 16 days after a dose of (dose number not specified) of mrna-1273 vaccine administration. medical history of autoimmune hypothyroidism remains as confounding. the benefit-risk relationship of mrna-1273 is not affected by this report. the events were assessed as serious as per regulatory authority�s report.; reporter's comments: autoimmune hypothyroidism.; sender's comments: this regulatory authority case concerns a 52 -years-old, male patient with relevant medical history of autoimmune hypothyroidism reported, who experienced unexpected serious events of dyspnoea, ophthalmoplegia, cardiac discomfort (seriousness criterion hospitalization), which occurred 16 days after a dose of (dose number not specified) of mrna-1273 vaccine administration. medical history of autoimmune hypothyroidism remains as confounding. the benefit-risk relationship of mrna-1273 is not affected by this report. the events were assessed as serious as per regulatory authority�s report

Données de laboratoire
na
Liste des symptômes
dyspnoea ophthalmoplegia cardiac discomfort
Patient décédé?
Non
Date de décès
N/A
Anomalie congénitale
false
Vaccin administré par :
Unknown
Vaccin acheté par :
Inconnu
Visite d’un patient à l’urgence?
Non
Patient hospitalisé?
Oui
Séjour à l’hôpital
Non
Nombre de jours à l’hôpital
Non spécifié
Invalidité permanente?
Non
Allergies:
na
Maladie actuelle
na