VAERS 1615044
MODERNA · COVID19 (COVID19 (MODERNA)) · Charge 0031M20A
- Staat
- MD
- Alter
- 75,0
- Geschlecht
- F
- Eingang
- 22.08.2021
- Impfdatum
- 03.03.2021
- Beginn
- 03.03.2021
- Tage bis Beginn
- 0,0
- Dosis
- 1
- Route/Site
- OT / LA
Symptomtext
Broke arm,broke her shoulder; 2nd dose was suppose to be on March 31st but on 30th she broke her shoulder; tenderness on injection site; This spontaneous case was reported by a consumer and describes the occurrence of LIMB INJURY (Broke arm,broke her shoulder), INJECTION SITE PAIN (tenderness on injection site) and PRODUCT DOSE OMISSION ISSUE (2nd dose was suppose to be on March 31st but on 30th she broke her shoulder) in a 75-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 0031M20A) for COVID-19 vaccination. No medical history was provided by the reporter. Concomitant products included LISINOPRIL, METOPROLOL, CHLORTHALIDONE, CLOPIDOGREL BISULFATE (PLAVIX), ACETYLSALICYLIC ACID (ASPRIN) and ROSUVASTATIN CALCIUM (CRESTOR) for an unknown indication. On 03-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 03-Mar-2021, the patient experienced INJECTION SITE PAIN (tenderness on injection site). On 30-Mar-2021, the patient experienced LIMB INJURY (Broke arm,broke her shoulder) and PRODUCT DOSE OMISSION ISSUE (2nd dose was suppose to be on March 31st but on 30th she broke her shoulder). On 30-Mar-2021, PRODUCT DOSE OMISSION ISSUE (2nd dose was suppose to be on March 31st but on 30th she broke her shoulder) had resolved. At the time of the report, LIMB INJURY (Broke arm,broke her shoulder) and INJECTION SITE PAIN (tenderness on injection site) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Treatment information was not provided. This case was linked to US-MODERNATX, INC.-MOD-2021-114387 (E2B Linked Report).; Sender's Comments: US-MODERNATX, INC.-MOD-2021-114387:Case for husband
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Injection site pain
- Hospital-Tage
- -
- Labordaten
- -
- Aktuelle Erkrankungen
- -
- Vorgeschichte
- Comments: No medical history was provided by the reporter.
- Andere Medikamente
- LISINOPRIL; METOPROLOL; CHLORTHALIDONE; PLAVIX; ASPRIN; CRESTOR
- Allergien
- -
- Vorherige Impfungen
- -