Adverse Event Reporting

VAERS ID 2298414
Gender Female
Age 85
StateCode CO
Pharmaceutical Company MODERNA
Lot Number 035C21A
Number of vaccinations
Vaccinated 2021-10-27
Onset 2021-10-27
Condition
Symptoms
  • Poor quality product administered
  • Product temperature excursion issue

Current Illness

Preexisting Conditions

Other Medications

Previous Vaccinations

Allergies

Laboratory Data

Write-up

Vaccine administered after more than 1 temperature excursion; Vaccine administered after more than 1 temperature excursion; This spontaneous case was reported by an other health care professional and describes the occurrence of PRODUCT TEMPERATURE EXCURSION ISSUE (Vaccine administered after more than 1 temperature excursion) and POOR QUALITY PRODUCT ADMINISTERED (Vaccine administered after more than 1 temperature excursion) in an 85-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no.
035C21A) for COVID-19 vaccination.
No Medical History information was reported.
On 27-Oct-2021 at 3:05 PM, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) .
25 milliliter.
On 27-Oct-2021, the patient experienced POOR QUALITY PRODUCT ADMINISTERED (Vaccine administered after more than 1 temperature excursion).
On an unknown date, the patient experienced PRODUCT TEMPERATURE EXCURSION ISSUE (Vaccine administered after more than 1 temperature excursion).
At the time of the report, PRODUCT TEMPERATURE EXCURSION ISSUE (Vaccine administered after more than 1 temperature excursion) and POOR QUALITY PRODUCT ADMINISTERED (Vaccine administered after more than 1 temperature excursion) outcome was unknown.
For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments.
The age of patient was provided as 85.
26.
Concomitant products were not provided.
On 27-Oct-2021, Excursion time was 09 AM, temperature was 29 and at 10 AM was 32 respectively, total doses given for the day was 116, condition of vaccine prior to administration was not frozen, vaccine was moved to fridge on 29-Sep-2021 and 05-Oct-2021, vial was moved to clinic on 27-Oct-2021.
02 and 04 vials were sent to clinic.
Vaccine BUD date was 29-Oct-2021 and 04-Nov-2021.
On 22-Oct-2021, vials were stored in cooler 1, at following time and temperature respectively, 8 AM: 41, 9 AM: 29, 10 AM: 32, 11 AM: 43, 12 AM: 43, 1PM: 43, 2 PM: 46, 3 PM: 46, 4 PM: 46 and 5 PM: 45.
The vials were only punctured right before administration and all doses were drawn from the vial due to high-pace clinic.
Temperature recordings were taken using a Fisher brand traceable temperature monitor at every hour.
After administration, the vial was returned to the freezer/refrigerator, or maintained at room temperature.
It was reported that the patient was administered with vaccines that experienced more than 1 temperature excursion during 33 weeks in 2021.
The HCP explained that each time a vial was put into a cooler, there was a period of 1 hour or 1 and half hour approximately, when the temperature data logger registered 34 or 35 degree F.
Treatment medications were not reported.