Détails du rapport Vaer
Âge: 87 ans
Genre: Female
Région : Outside US
- Patient décédé?
- Non
- Renseignements sur les vaccins
-
Nom: COVID19 (COVID19 (MODERNA))
Type : Coronavirus 2019 vaccine
Fabricant: MODERNA
Lot: 030g21a
- Date de réception du rapport
- 2022-03-04
- Date à laquelle le formulaire est complèté
- Date de vaccination
- 2021-12-24
- Date d’apparition
- 38
- Nombre de jours (date d’apparition – date de vaccination)
- 38
- Description de l’événement indésirable
-
acute coronary heart syndrome and positivity for sars cov 2 in trivaccinate; acute coronary heart syndrome and positivity for sars cov 2 in trivaccinate; this case was received (reference number: it-minisal02-841031) on 24-feb-2022 and was forwarded to moderna on 24-feb-2022. this regulatory authority case was reported by a physician and describes the occurrence of covid-19 (acute coronary heart syndrome and positivity for sars cov 2 in trivaccinate) and acute coronary syndrome (acute coronary heart syndrome and positivity for sars cov 2 in trivaccinate) in an 87-year-old female patient who received mrna-1273 (spikevax) (batch no. 030g21a) for covid-19 vaccination. no medical history information was reported. on 24-dec-2021, the patient received dose of mrna-1273 (spikevax) (intramuscular) .25 milliliter. on 31-jan-2022, the patient experienced covid-19 (acute coronary heart syndrome and positivity for sars cov 2 in trivaccinate) (seriousness criterion hospitalization) and acute coronary syndrome (acute coronary heart syndrome and positivity for sars cov 2 in trivaccinate) (seriousness criterion hospitalization). at the time of the report, covid-19 (acute coronary heart syndrome and positivity for sars cov 2 in trivaccinate) and acute coronary syndrome (acute coronary heart syndrome and positivity for sars cov 2 in trivaccinate) outcome was unknown. diagnostic results (normal ranges are provided in parenthesis if available): on 31-jan-2022, sars-cov-2 test: inconclusive (inconclusive) inconclusive. the action taken with mrna-1273 (spikevax) (intramuscular) was unknown. for mrna-1273 (spikevax) (intramuscular), the reporter did not provide any causality assessments. no concomitant medications were provided. no treatment medications were provided. additional information on drug was reported as abuse/misuse. company comment: this regulatory authority case concerns an 87-year-old female patient, with no medical history reported, who experienced the unexpected serious aesi of covid-19 and acute coronary syndrome. the events occurred approximately 1 month 8 days after receiving a dose of mrna-1273 vaccine and resulted in hospitalization. at the time of the report the outcome of the events was unknown. additional information on drug was reported as abuse/misuse. the benefit-risk relationship of mrna-1273 vaccine is not affected by this report.; sender's comments: this regulatory authority case concerns an 87-year-old female patient, with no medical history reported, who experienced the unexpected serious aesi of covid-19 and acute coronary syndrome. the events occurred approximately 1 month 8 days after receiving a dose of mrna-1273 vaccine and resulted in hospitalization. at the time of the report the outcome of the events was unknown. additional information on drug was reported as abuse/misuse. the benefit-risk relationship of mrna-1273 vaccine is not affected by this report
- Données de laboratoire
-
test date: 20220131; test name: covid-19 pcr test; test result: inconclusive ; result unstructured data: inconclusive
- Liste des symptômes
-
covid-19 sars-cov-2 test acute coronary syndrome
- 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