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VAERS Report 2157203

Case Report Section

Vaer Report Details

Age: 42 years old

Gender: Female

State: Outside US

Patient Died?
No
Vaccine information

Name: COVID19 (COVID19 (MODERNA))

Type: Coronavirus 2019 vaccine

Manufacturer: MODERNA

Lot: 216037


Date report was received
2022-03-04
Date form completed
Date Vaccinated
2022-01-25
Date of Onset
1
Number of days (onset date – vaccination date)
1
Adverse Event Description

first aid hospitalization with muscle contractions and leg pain, back from the day after inoculated vaccine moderna third dose, day 3 strong tachycardia with pressure throat and chest; first aid hospitalization with muscle contractions and leg pain, back from the day after inoculated vaccine moderna third dose, day 3 strong tachycardia with pressure throat and chest.; first aid hospitalization with muscle contractions and leg pain, back from the day after inoculated vaccine moderna third dose, day 3 strong tachycardia with pressure throat and chest.; first aid hospitalization with muscle contractions and leg pain, back from the day after inoculated vaccine moderna third dose, day 3 strong tachycardia with pressure throat and chest.; this case was received via regulatory authority (reference number: it-regulatory authority02-840309) 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 back pain (first aid hospitalization with muscle contractions and leg pain, back from the day after inoculated vaccine moderna third dose, day 3 strong tachycardia with pressure throat and chest), pain in extremity (first aid hospitalization with muscle contractions and leg pain, back from the day after inoculated vaccine moderna third dose, day 3 strong tachycardia with pressure throat and chest.), muscle twitching (first aid hospitalization with muscle contractions and leg pain, back from the day after inoculated vaccine moderna third dose, day 3 strong tachycardia with pressure throat and chest.) and tachycardia (first aid hospitalization with muscle contractions and leg pain, back from the day after inoculated vaccine moderna third dose, day 3 strong tachycardia with pressure throat and chest.) in a 42-year-old female patient who received mrna-1273 (spikevax) (batch no. 216037) for sars-cov-2 vaccination. concurrent medical condition included hypertension, nichel allergy and mild essential tremor. previously administered products included for product used for unknown indication: comirnaty (biontech manufacturing gmbh) (j07bx03 on 16-jul-2021 and comirnaty (biontech manufacturing gmbh) (j07bx03 on 22-aug-2021.past adverse reactions to the above products included no adverse event with comirnaty (biontech manufacturing gmbh) (j07bx03 and comirnaty (biontech manufacturing gmbh) (j07bx03.concomitant products included irbesartan for an unknown indication.on 25-jan-2022, the patient received dose of mrna-1273 (spikevax) (intramuscular) 1 dosage form. on 26-jan-2022, the patient experienced back pain (first aid hospitalization with muscle contractions and leg pain, back from the day after inoculated vaccine moderna third dose, day 3 strong tachycardia with pressure throat and chest) (seriousness criterion hospitalization), pain in extremity (first aid hospitalization with muscle contractions and leg pain, back from the day after inoculated vaccine moderna third dose, day 3 strong tachycardia with pressure throat and chest.) (seriousness criterion hospitalization), muscle twitching (first aid hospitalization with muscle contractions and leg pain, back from the day after inoculated vaccine moderna third dose, day 3 strong tachycardia with pressure throat and chest.) (seriousness criterion hospitalization) and tachycardia (first aid hospitalization with muscle contractions and leg pain, back from the day after inoculated vaccine moderna third dose, day 3 strong tachycardia with pressure throat and chest.) (seriousness criterion hospitalization). at the time of the report, back pain (first aid hospitalization with muscle contractions and leg pain, back from the day after inoculated vaccine moderna third dose, day 3 strong tachycardia with pressure throat and chest), pain in extremity (first aid hospitalization with muscle contractions and leg pain, back from the day after inoculated vaccine moderna third dose, day 3 strong tachycardia with pressure throat and chest.), muscle twitching (first aid hospitalization with muscle contractions and leg pain, back from the day after inoculated vaccine moderna third dose, day 3 strong tachycardia with pressure throat and chest.) and tachycardia (first aid hospitalization with muscle contractions and leg pain, back from the day after inoculated vaccine moderna third dose, day 3 strong tachycardia with pressure throat and chest.) was resolving. the action taken with mrna-1273 (spikevax) (intramuscular) was unknown. treatment information was unknown. this is a regulatory case concerning a 42-year-old female patient with no relevant medical history, who experienced the unexpected serious events of back pain, muscle twitching, pain in extremity, and tachycardia. the events led to the hospitalization of the patient as reported by the regulatory authority. the events occurred in 1 day after receiving an unspecified dose of mrna-1273 vaccine. no clinical or treatment details were given. it was reported that the outcome of the event was resolving. the benefit-risk relationship of mrna-1273 vaccine is not affected by this report. sender's comments: this is a regulatory case concerning a 42-year-old female patient with no relevant medical history, who experienced the unexpected serious events of back pain, muscle twitching, pain in extremity, and tachycardia. the events led to the hospitalization of the patient as reported by the regulatory authority. the events occurred in 1 day after receiving an unspecified dose of mrna-1273 vaccine. no clinical or treatment details were given. it was reported that the outcome of the event was resolving. the benefit-risk relationship of mrna-1273 vaccine is not affected by this report

Lab Data
na
List of symptoms
muscle twitching back pain pain in extremity tachycardia
Patient Died?
No
Date Died
NA
Birth defect
false
Vaccine Administered By:
Unknown
Vaccine Purchased By:
Unknown
Patient visit ER?
No
Patient Hospitalized?
Yes
Stay in hospital
No
Days in hospital
Unspecified
Permanent disability?
No
Allergies:
na
Current Illness
na