Adverse Event Reporting

VAERS ID 1100240
Gender Female
Age
StateCode MI
Pharmaceutical Company MODERNA
Lot Number 023M20A
Number of vaccinations 1
Vaccinated 2021-02-22
Onset 2021-02-23
Condition Hospitalized Life Threatening
Symptoms
  • Fatigue
  • Chills
  • Dyspnoea
  • Oxygen saturation
  • Haemorrhage intracranial

Current Illness

Preexisting Conditions

Medical History/Concurrent Conditions: No adverse event (No medical history reported.)

Other Medications

Previous Vaccinations

Allergies

Laboratory Data

Test Date: 20210222; Test Name: Pulse oximetry; Test Result: 81 %; Result Unstructured Data: 81% Room Air

Write-up

Intercranial hemorrhage/brain bleed; Chills; Fatigue; Really bad shortness of breath; A spontaneous report was received from a pharmacist regarding a 64-year-old female consumer, unknown race, and ethnicity, who experienced intracranial hemorrhage, chills, fatigue, and dyspnoea.
The patient's medical history was not provided.
Concomitant product use was not provided by the reporter.
On 22 Feb 2021, prior to the onset of symptoms, the patient received one of her two planned doses of mRNA-1273 vaccine intramuscularly for the prophylaxis of Covid-19 infection (Batch# 023M20A).
On 22 Feb 2021, 7 hours post-vaccination, the patient developed symptoms of chills, fatigue, and a "really bad" shortness of breath with a pulse oximetry reading of 81% on room air.
On 23 Feb 2021, the patient was hospitalzed and subsequently transferred to a sister hospital for an intracranial hemorrhage/brain bleed.
Lab investigations and treatment details were not provided.
Action taken with mRNA-1273 in response to the events was not provided.
The outcome of the events, intracranial hemorrhage/brain bleed, chills, fatigue, and shortness of breath, was unknown at the time of the report.
; Reporter's Comments: Very limited information regarding this events has been provided at this time.
Further information has been requested.