Adverse Event Reporting

VAERS ID	1128053
Gender	Female
Age
StateCode
Pharmaceutical Company	MODERNA
Lot Number
Number of vaccinations	1
Vaccinated	2021-03-14
Onset	2021-03-15
Condition	Permanent Disability

Symptoms

• Deafness unilateral

Current Illness

Preexisting Conditions

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

Other Medications

Previous Vaccinations

Allergies

Laboratory Data

Write-up

Lost hearing in one ear; A spontaneous report was received from a consumer concerning an age unspecified, female patient, who received Moderna's COVID-19 vaccine (mRNA-1273) and experienced loss of hearing in one ear.
The patient's medical history was not provided.
Concomitant medications were not provided.
On 14 Mar 2021, approximately a day prior to the onset of the events, the patient received their first of the two planned doses of mRNA-1273 (Batch number: unknown) intramuscularly for prophylaxis of COVID-19 infection.
On the morning of 15 Mar 2021, the reporter states that her sister had no hearing in one ear.
Treatment information was not provided by reporter.
Lab tests were not provided.
Action taken with mRNA-1273 in response to the events was not reported.
The outcome of the events, lost hearing in one ear, was considered unknown.
; Reporter's Comments: Very limited information regarding this event has been provided at this time.
Further information has been requested.