Adverse Event Reporting

VAERS ID 2294617
Gender Female
Age 83
StateCode FL
Pharmaceutical Company MODERNA
Lot Number 051F21A
Number of vaccinations 3
Vaccinated 2021-10-30
Onset 2022-05-17
Condition Hospitalized
  • Dyspnoea
  • Chest pain
  • Vomiting
  • Cough
  • Abdominal pain
  • Back pain
  • SARS-CoV-2 test positive
  • COVID-19
  • Computerised tomogram abdomen abnormal
  • Bronchitis
  • Cholelithiasis
  • Bile duct stone
  • Coronavirus test positive
  • Influenza A virus test positive
  • Endoscopic retrograde cholangiopancreatography abnormal

Current Illness

Preexisting Conditions

Asthma, HTN, HLD

Other Medications

Previous Vaccinations


codeine, PCN, Sulfadiazine

Laboratory Data

SARS CoV PCR COVID 19 positive, Influenza A H3 PCR, Coronavirus 229E PCR were positive on 5/17/22.


She received Moderna COVID vaccines on 12/30/20, 1/27/2021, and 10/30/2021.
She presented to the ED of a local HCF with 2 days of vomiting, chest pain, cough, SOB, back pain and abdominal pain on 5/17/22.
Her COVID test resulted in positive.
She was also tested positive with non-covid Coronavirus 229E PCR and Influenza A H3 PCR.
Her CT showed choledocholithiasis, and she was admitted for acute bronchitis and choledocholithiasis management on the same day.
She was given steroids, Ceftriaxone, Oseltamivir, Zosyn.
She had ERCP for gallstone.
She was one point on 4L of oxygen.
She was medically stable, not required supplemental oxygen, and she was discharge to the local skilled nursing facility on 5/25/22.