Adverse Event Reporting

VAERS ID 1864252
Gender Male
Age 70
StateCode MD
Pharmaceutical Company MODERNA
Lot Number 939904
Number of vaccinations 3
Vaccinated 2021-11-04
Onset 2021-11-05
Condition
Symptoms
  • Fatigue
  • Feeling abnormal
  • Myalgia
  • Influenza like illness

Current Illness

Preexisting Conditions

Other Medications

Previous Vaccinations

Allergies

Laboratory Data

Write-up

not feeling up to par; with flu like symptoms that are not nearly as severe as after the 2nd shot; a little tired; feeling a little bit the the usual achy; This spontaneous case was reported by a consumer and describes the occurrence of FEELING ABNORMAL (not feeling up to par), INFLUENZA LIKE ILLNESS (with flu like symptoms that are not nearly as severe as after the 2nd shot), MYALGIA (feeling a little bit the the usual achy) and FATIGUE (a little tired) in a 70-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no.
939904) for COVID-19 vaccination.
No Medical History information was reported.
On 04-Nov-2021, the patient received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form.
On 05-Nov-2021, the patient experienced MYALGIA (feeling a little bit the the usual achy).
On an unknown date, the patient experienced FEELING ABNORMAL (not feeling up to par), INFLUENZA LIKE ILLNESS (with flu like symptoms that are not nearly as severe as after the 2nd shot) and FATIGUE (a little tired).
At the time of the report, FEELING ABNORMAL (not feeling up to par), INFLUENZA LIKE ILLNESS (with flu like symptoms that are not nearly as severe as after the 2nd shot), MYALGIA (feeling a little bit the the usual achy) and FATIGUE (a little tired) outcome was unknown.
Concomitant medication was not provided.
Treatment information was not provided.
This case was linked to MOD-2021-089432 (Patient Link).