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VAERS Report 2157272

Case Report Section

Détails du rapport Vaer

Âge: 86 ans

Genre: Male

Région : Outside US

Patient décédé?
Non
Renseignements sur les vaccins

Nom: COVID19 (COVID19 (MODERNA))

Type : Coronavirus 2019 vaccine

Fabricant: MODERNA

Lot: 016g21a


Date de réception du rapport
2022-03-04
Date à laquelle le formulaire est complèté
Date de vaccination
2021-12-10
Date d’apparition
13
Nombre de jours (date d’apparition – date de vaccination)
13
Description de l’événement indésirable

enterocarditis and right eye swelling; enterocarditis and right eye swelling; this case was received (reference number: it-minisal02-841779) on 28-feb-2022 and was forwarded to moderna on 28-feb-2022. this regulatory authority case was reported by a consumer and describes the occurrence of eye oedema (enterocarditis and right eye swelling) and endocarditis (enterocarditis and right eye swelling) in an 86-year-old male patient who received mrna-1273 (spikevax) (batch no. 016g21a) for covid-19 vaccination. no medical history information was reported. on 10-dec-2021, the patient received dose of mrna-1273 (spikevax) (intramuscular) .5 milliliter. on 23-dec-2021, the patient experienced eye oedema (enterocarditis and right eye swelling) (seriousness criterion hospitalization) and endocarditis (enterocarditis and right eye swelling) (seriousness criterion hospitalization). at the time of the report, eye oedema (enterocarditis and right eye swelling) and endocarditis (enterocarditis and right eye swelling) had not resolved. the action taken with mrna-1273 (spikevax) (intramuscular) was unknown. no concomitant medications were reported. no treatment details were reported. company comment this is a regulatory case concerning a 86-year-old male patient with no medical history reported, who experienced the serious, due to hospitalization, unexpected events of eye oedema and endocarditis (verbatim: enterocarditis and right eye swelling), which occurred approximately 13 days after a dose of mrna-1273. no further information regarding the clinical course and treatment of the events were provided. the benefit-risk relationship of mrna-1273 vaccine is not affected by this report.; sender's comments: this is a regulatory case concerning a 86-year-old male patient with no medical history reported, who experienced the serious, due to hospitalization, unexpected events of eye oedema and endocarditis (verbatim: enterocarditis and right eye swelling), which occurred approximately 13 days after a dose of mrna-1273. no further information regarding the clinical course and treatment of the events were provided. the benefit-risk relationship of mrna-1273 vaccine is not affected by this report

Données de laboratoire
na
Liste des symptômes
endocarditis eye oedema
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