Détails du rapport Vaer
Âge: 52 ans
Genre: Female
Région : Outside US
- Patient décédé?
- Non
- Renseignements sur les vaccins
-
Nom: COVID19 (COVID19 (MODERNA))
Type : Coronavirus 2019 vaccine
Fabricant: MODERNA
Lot: 3002622sc5/12
- Date de réception du rapport
- 2022-03-04
- Date à laquelle le formulaire est complèté
- Date de vaccination
- 2021-07-20
- Date d’apparition
- 0
- Nombre de jours (date d’apparition – date de vaccination)
- 0
- Description de l’événement indésirable
-
anticovid vaccination carried out on 20/07/2021. hyperpyrexia in the evening, at night it reached 39.6 c, at night i had convulsions. communicated to the doctor the day after which he tells me (continued); anticovid vaccination carried out on 20/07/2021. hyperpyrexia in the evening, at night it reached 39.6 c, at night i had convulsions. communicated to the doctor the day after which he tells me (continued); anticovid vaccination carried out on 20/07/2021. hyperpyrexia in the evening, at night it reached 39.6 c, at night i had convulsions. communicated to the doctor the day after which he tells me (continued); anticovid vaccination carried out on 20/07/2021. hyperpyrexia in the evening, at night it reached 39.6 c, at night i had convulsions. communicated to the doctor the day after which he tells me (continued); anticovid vaccination carried out on 20/07/2021. hyperpyrexia in the evening, at night it reached 39.6 c, at night i had convulsions. communicated to the doctor the day after which he tells me (continued); anticovid vaccination carried out on 20/07/2021. hyperpyrexia in the evening, at night it reached 39.6 c, at night i had convulsions. communicated to the doctor the day after which he tells me (continued); anticovid vaccination carried out on 20/07/2021. hyperpyrexia in the evening, at night it reached 39.6 c, at night i had convulsions. communicated to the doctor the day after which he tells me (continued); anticovid vaccination carried out on 20/07/2021. hyperpyrexia in the evening, at night it reached 39.6 c, at night i had convulsions. communicated to the doctor the day after which he tells me (continued); this case was received (reference number: it-minisal02-840480) 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 vaccination site oedema (anticovid vaccination carried out on 20/07/2021. hyperpyrexia in the evening, at night it reached 39.6 c, at night i had convulsions. communicated to the doctor the day after which he tells me (continued)), insomnia (anticovid vaccination carried out on 20/07/2021. hyperpyrexia in the evening, at night it reached 39.6 c, at night i had convulsions. communicated to the doctor the day after which he tells me (continued)), hyperpyrexia (anticovid vaccination carried out on 20/07/2021. hyperpyrexia in the evening, at night it reached 39.6 c, at night i had convulsions. communicated to the doctor the day after which he tells me (continued)), palpitations (anticovid vaccination carried out on 20/07/2021. hyperpyrexia in the evening, at night it reached 39.6 c, at night i had convulsions. communicated to the doctor the day after which he tells me (continued)), pain in extremity (anticovid vaccination carried out on 20/07/2021. hyperpyrexia in the evening, at night it reached 39.6 c, at night i had convulsions. communicated to the doctor the day after which he tells me (continued)), seizure (anticovid vaccination carried out on 20/07/2021. hyperpyrexia in the evening, at night it reached 39.6 c, at night i had convulsions. communicated to the doctor the day after which he tells me (continued)), eye irritation (anticovid vaccination carried out on 20/07/2021. hyperpyrexia in the evening, at night it reached 39.6 c, at night i had convulsions. communicated to the doctor the day after which he tells me (continued)) and fatigue (anticovid vaccination carried out on 20/07/2021. hyperpyrexia in the evening, at night it reached 39.6 c, at night i had convulsions. communicated to the doctor the day after which he tells me (continued)) in a 52-year-old female patient who received mrna-1273 (spikevax) (batch no. 3002622 sc 5/12/21) for covid-19 vaccination. no medical history information was reported. on 20-jul-2021, the patient received dose of mrna-1273 (spikevax) (intramuscular) 1 dosage form. on 20-jul-2021, the patient experienced vaccination site oedema (anticovid vaccination carried out on 20/07/2021. hyperpyrexia in the evening, at night it reached 39.6 c, at night i had convulsions. communicated to the doctor the day after which he tells me (continued)) (seriousness criterion medically significant), insomnia (anticovid vaccination carried out on 20/07/2021. hyperpyrexia in the evening, at night it reached 39.6 c, at night i had convulsions. communicated to the doctor the day after which he tells me (continued)) (seriousness criterion medically significant), hyperpyrexia (anticovid vaccination carried out on 20/07/2021. hyperpyrexia in the evening, at night it reached 39.6 c, at night i had convulsions. communicated to the doctor the day after which he tells me (continued)) (seriousness criterion medically significant), palpitations (anticovid vaccination carried out on 20/07/2021. hyperpyrexia in the evening, at night it reached 39.6 c, at night i had convulsions. communicated to the doctor the day after which he tells me (continued)) (seriousness criterion medically significant), pain in extremity (anticovid vaccination carried out on 20/07/2021. hyperpyrexia in the evening, at night it reached 39.6 c, at night i had convulsions. communicated to the doctor the day after which he tells me (continued)) (seriousness criterion medically significant), seizure (anticovid vaccination carried out on 20/07/2021. hyperpyrexia in the evening, at night it reached 39.6 c, at night i had convulsions. communicated to the doctor the day after which he tells me (continued)) (seriousness criterion medically significant), eye irritation (anticovid vaccination carried out on 20/07/2021. hyperpyrexia in the evening, at night it reached 39.6 c, at night i had convulsions. communicated to the doctor the day after which he tells me (continued)) (seriousness criterion medically significant) and fatigue (anticovid vaccination carried out on 20/07/2021. hyperpyrexia in the evening, at night it reached 39.6 c, at night i had convulsions. communicated to the doctor the day after which he tells me (continued)) (seriousness criterion medically significant). at the time of the report, vaccination site oedema (anticovid vaccination carried out on 20/07/2021. hyperpyrexia in the evening, at night it reached 39.6 c, at night i had convulsions. communicated to the doctor the day after which he tells me (continued)), insomnia (anticovid vaccination carried out on 20/07/2021. hyperpyrexia in the evening, at night it reached 39.6 c, at night i had convulsions. communicated to the doctor the day after which he tells me (continued)), hyperpyrexia (anticovid vaccination carried out on 20/07/2021. hyperpyrexia in the evening, at night it reached 39.6 c, at night i had convulsions. communicated to the doctor the day after which he tells me (continued)), palpitations (anticovid vaccination carried out on 20/07/2021. hyperpyrexia in the evening, at night it reached 39.6 c, at night i had convulsions. communicated to the doctor the day after which he tells me (continued)), pain in extremity (anticovid vaccination carried out on 20/07/2021. hyperpyrexia in the evening, at night it reached 39.6 c, at night i had convulsions. communicated to the doctor the day after which he tells me (continued)), seizure (anticovid vaccination carried out on 20/07/2021. hyperpyrexia in the evening, at night it reached 39.6 c, at night i had convulsions. communicated to the doctor the day after which he tells me (continued)), eye irritation (anticovid vaccination carried out on 20/07/2021. hyperpyrexia in the evening, at night it reached 39.6 c, at night i had convulsions. communicated to the doctor the day after which he tells me (continued)) and fatigue (anticovid vaccination carried out on 20/07/2021. hyperpyrexia in the evening, at night it reached 39.6 c, at night i had convulsions. communicated to the doctor the day after which he tells me (continued)) had not resolved. the action taken with mrna-1273 (spikevax) (intramuscular) was unknown. no concomitant medications were reported modern vaccine n dose (2) taken on 20/07/2031 at 9:11 am batch 3003655 expiry 31/12/2021, im left arm. no treatment medications were reported. company comment: this is a regulatory case concerning a 52-years-old female patient with no significant clinical history who experienced the unexpected events of seizure (aesi), vaccination site oedema, insomnia, hyperpyrexia, palpitations, pain in extremity, eye irritation and fatigue 1 days after a dose of rna-1273. the benefit-risk relationship of mrna-1273 vaccine is not affected by this report. terms and onset were captured as provided. the case was assessed as serious by the regulatory authority�s report due to ime; reporter's comments: adr received by e-mail to the cesena pv manager on 5/2/22 from , with only the description of the adr, without a completed form. modern vaccine n. dose (2) taken on 20/07/2031 at 9:11 am batch 3003655 expiry 31/12/2021, im left arm.; sender's comments: company comment: this is a regulatory case concerning a 52-years-old female patient with no significant clinical history who experienced the unexpected events of seizure (aesi), vaccination site oedema, insomnia, hyperpyrexia, palpitations, pain in extremity, eye irritation and fatigue 1 days after a dose of rna-1273. the benefit-risk relationship of mrna-1273 vaccine is not affected by this report. terms and onset were captured as provided. the case was assessed as serious by the regulatory authority�s report due to ime
- Données de laboratoire
-
na
- Liste des symptômes
-
fatigue pain in extremity insomnia palpitations eye irritation seizure vaccination site oedema hyperpyrexia
- 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?
- Non
- Séjour à l’hôpital
- Non
- Nombre de jours à l’hôpital
- Non spécifié
- Invalidité permanente?
- Non
- Allergies:
-
na
- Maladie actuelle
-
na