Adverse Event Reporting

VAERS ID 2558137
Gender Unknown
Age 83
StateCode
Pharmaceutical Company MODERNA
Lot Number ASKU
Number of vaccinations 2
Vaccinated
Onset
Condition
Symptoms
  • COVID-19

Current Illness

Preexisting Conditions

Medical History/Concurrent Conditions: COVID-19 (Jan-2023); COVID-19; Comments: Question: Describe relevant medical history/conditions, allergy, concomitant diseases and risk factor. Answer:Covid-19: August 2019 & January 2023.

Other Medications

Previous Vaccinations

Allergies

Laboratory Data

Write-up

covid 19; This spontaneous case was reported by a patient and describes the occurrence of COVID-19 (covid 19) in an 83-year-old patient of an unknown gender who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no.
ASKU) for COVID-19 prophylaxis.
Question:Describe relevant medical history/conditions, allergy, concomitant diseases and risk factor.
Answer:Covid-19: August 2019 & January 2023.
The patient's past medical history included COVID-19 in August 2019 and COVID-19 (Jan-2023).
On an unknown date, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form.
On an unknown date, the patient experienced COVID-19 (covid 19).
At the time of the report, COVID-19 (covid 19) outcome was unknown.
For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments.
No concomitant medication information provided.
It was reported that patient had covid-19 in Aug 2019.
April and May 2020 got vaccinated.
In Jan-2023 caught covid-19 for 2nd time.
No treatment information provided.
Most recent FOLLOW-UP information incorporated above includes: On 08-Jan-2023: Live follow up contains no new information.