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VAERS Report 2157230

Case Report Section

Détails du rapport Vaer

Âge: 77 ans

Genre: Male

Région : Outside US

Patient décédé?
Non
Renseignements sur les vaccins

Nom: COVID19 (COVID19 (MODERNA))

Type : Coronavirus 2019 vaccine

Fabricant: MODERNA

Lot: 216037


Date de réception du rapport
2022-03-04
Date à laquelle le formulaire est complèté
Date de vaccination
2022-02-02
Date d’apparition
2
Nombre de jours (date d’apparition – date de vaccination)
2
Description de l’événement indésirable

impossibility to stand in balance and walk; impossibility to stand in balance and walk; impossibility to stand in balance and walk; this regulatory authority case was reported by a consumer and describes the occurrence of gait disturbance (impossibility to stand in balance and walk), balance disorder (impossibility to stand in balance and walk) and dysstasia (impossibility to stand in balance and walk) in a 77-year-old male patient who received mrna-1273 (spikevax) (batch no. 216037) for covid-19 vaccination. 1st dose comirnaty on 22 april 2021 at 12.13 pm left shoulder lot ex0893 expired on 31 july 2021. 2nd dose comirnaty on 14 may 2021 at 11.41 left shoulder lot fa4597 expired on 31 august 2021. concomitant products included nebivolol hydrochloride (lobivon) from 22-dec-2021 to an unknown date, doxazosin mesilate (cardura) from 09-oct-2013 to an unknown date, furosemide (furosemide flx) from 13-apr-2014 to an unknown date, calcitriol (rocaltrol) from 26-oct-2017 to an unknown date and folic acid (folinal) from 22-dec-2021 to an unknown date for renal failure, ezetimibe from 25-oct-2016 to an unknown date, ursodeoxycholic acid (deursil) from 22-dec-2021 to an unknown date, lactobacillus acidophilus (acido) from 29-dec-2009 to an unknown date, valproate sodium (depakin) from 22-dec-2021 to an unknown date and calcitriol (rocaltrol) from 22-dec-2021 to an unknown date for an unknown indication. on 02-feb-2022, the patient received dose of mrna-1273 (spikevax) (intramuscular) .25 milliliter. on 04-feb-2022, the patient experienced gait disturbance (impossibility to stand in balance and walk) (seriousness criterion hospitalization), balance disorder (impossibility to stand in balance and walk) (seriousness criterion hospitalization) and dysstasia (impossibility to stand in balance and walk) (seriousness criterion hospitalization). at the time of the report, gait disturbance (impossibility to stand in balance and walk), balance disorder (impossibility to stand in balance and walk) and dysstasia (impossibility to stand in balance and walk) had not resolved. the action taken with mrna-1273 (spikevax) (intramuscular) was unknown. no treatment information was provided. sender's comment: 1st dose comirnaty 22/04/2021 at 12.13 pm left shoulder lot: ex0893 expires 31/07/2021. 2nd dose comirnaty 14/05/2021 at 11.41 left shoulder lot: fa4597 expired 31/08/2021. access in p.s on 04/02/2022 and admission in neurology. this is a regulatory authority case concerning a 77-year-old, male patient with no relevant medical history, who experienced the unexpected events of gait disturbance, balance disorder, dysstasia. the events occurred 2 days after the unspecified dose of mrna-1273 covid 19 vaccine. no treatment information was provided. the events were reported as not resolved. the benefit-risk relationship of mrna-1273 covid 19 vaccine, is not affected by this report.; reporter's comments: metabolic picture of important ir (close to dialysis).; sender's comments: this is a regulatory authority case concerning a 77-year-old, male patient with no relevant medical history, who experienced the unexpected events of gait disturbance, balance disorder, dysstasia. the events occurred 2 days after the unspecified dose of mrna-1273 covid 19 vaccine. no treatment information was provided. the events were reported as not resolved. the benefit-risk relationship of mrna-1273 covid 19 vaccine, is not affected by this report

Données de laboratoire
na
Liste des symptômes
gait disturbance balance disorder dysstasia
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