Adverse Event Reporting
| VAERS ID | 1245365 |
|---|---|
| Gender | Female |
| Age | |
| StateCode | OH |
| Pharmaceutical Company | MODERNA |
| Lot Number | |
| Number of vaccinations | 1 |
| Vaccinated | 2021-03-13 |
| Onset | 2021-04-01 |
| Condition | Hospitalized Life Threatening Permanent Disability |
Symptoms
- Visual impairment
- Cranial nerve disorder
- Gait disturbance
- Diplopia
- Cerebrovascular accident
- Paralysis
Current Illness
Obesity (BMI 45-45.9)
Preexisting Conditions
Other Medications
Previous Vaccinations
Allergies
Laboratory Data
Write-up
CVA isolated; Diplopia (left eye); Left with a palsy; Inability to walk confidently; Left cranial nerves VI, and III show deficit's; Cannot see out of left eye; This spontaneous case was reported by a health care professional (subsequently medically confirmed) and describes the occurrence of CEREBROVASCULAR ACCIDENT (CVA isolated), DIPLOPIA (Diplopia (left eye)), PARALYSIS (Left with a palsy), GAIT DISTURBANCE (Inability to walk confidently), CRANIAL NERVE DISORDER (Left cranial nerves VI, and III show deficit's) and VISUAL IMPAIRMENT (Cannot see out of left eye) in a 66-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 immunisation.
Concurrent medical conditions included Obesity (BMI 45-45.
9).
On 13-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form.
On 01-Apr-2021, the patient experienced CEREBROVASCULAR ACCIDENT (CVA isolated) (seriousness criteria hospitalization, disability, medically significant and life threatening) and DIPLOPIA (Diplopia (left eye)) (seriousness criteria hospitalization, disability and medically significant).
On 12-Apr-2021, the patient experienced PARALYSIS (Left with a palsy) (seriousness criteria disability and medically significant), GAIT DISTURBANCE (Inability to walk confidently) (seriousness criteria disability and medically significant), CRANIAL NERVE DISORDER (Left cranial nerves VI, and III show deficit's) (seriousness criteria disability and medically significant) and VISUAL IMPAIRMENT (Cannot see out of left eye) (seriousness criteria disability and medically significant).
At the time of the report, CEREBROVASCULAR ACCIDENT (CVA isolated), DIPLOPIA (Diplopia (left eye)), PARALYSIS (Left with a palsy), GAIT DISTURBANCE (Inability to walk confidently), CRANIAL NERVE DISORDER (Left cranial nerves VI, and III show deficit's) and VISUAL IMPAIRMENT (Cannot see out of left eye) outcome was unknown.
The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown.
For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments.
The Patient was Treated with Lovenox, Coumadin, Brimonidine eye drops.
The patient has been taking High Blood Pressure Medication,Severe Obesity medications and Hyperlipidemic Medications.
The patient has no known Allergies.
Company Comment: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.
; Sender's Comments: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.