Adverse Event Reporting
| VAERS ID | 999135 |
|---|---|
| Gender | Female |
| Age | 53 |
| StateCode | MA |
| Pharmaceutical Company | MODERNA |
| Lot Number | 013L20A |
| Number of vaccinations | 1 |
| Vaccinated | 2021-01-15 |
| Onset | 2021-01-18 |
| Condition | Permanent Disability |
Symptoms
- Arthralgia
- Pain in extremity
- Hypoaesthesia
- Paraesthesia
- Pain
- Injection site pain
- Injection site erythema
- Injection site swelling
- Chest X-ray normal
- Eosinophil count normal
- White blood cell count normal
- Axillary pain
- Blood creatine phosphokinase normal
- Blood alkaline phosphatase increased
- X-ray limb normal
- Ultrasound Doppler normal
Current Illness
none
Preexisting Conditions
HTN HEARING LOSS SENSORINEURAL Vit B12 deficiency Vit D deficiency +PPD
Other Medications
ciprofloxacin-dexamethasone (CIPRODEX) otic suspension. unclear if was taking this but on her med list. amLODIPine (NORVASC) 2.5 MG tablet, unclear if was taking this but on her med list. Vit B 12 and D supplements
Previous Vaccinations
Allergies
Apples, cranberries - facial swellilng and itching Anaphylaxis to seafood Canasa [Mesalamine] - rash Bactrim [Sulfamethoxazole-trimethoprim] Shortness of Breath, Rash
Laboratory Data
XR L Shoulder 1/27/21 Impression: No acute fracture or dislocation of the left shoulder.
XR L Humerus 1/27/21 Impression: No acute fracture or dislocation of the left humerus.
CXR 1/27/21 IMPRESSION: No acute cardiopulmonary findings on portable chest radiograph.
US L UE 1/27/21 IMPRESSION: No sonographic evidence of left upper extremity deep venous thrombus.
CREATINE KINASE TOTAL 57 on 1/27/21 ALK Phos 129
Write-up
No trauma Got dose, works as cleaner.
Received in Left deltoid.
Lot 013L20A Moderna.
For first 3 days, had typical pain she would receive from influenza vaccination 3 days after started to have redness at injection site as well as swelling.
Swelling subsided but as soon as swelling improved, pain got worse radiating from shoulder down arpit and to left hand.
Numbness and tingling also radiated distally.
3 ED visits--on 1/25 and two on 1/27 giving APAP, diclofenac gel, lidocaine patch, and sling.
Workup showed mildly elevated alk phos (129), CK normal 57, WBC unremarkable with absolute eois wnl.
XR imaging unremarkable.
No DVT L upper extremity.
Today, pain in deltoid controlled with APAP 500mg x 2 along with lidocaine patch.
But biggest concern for patient is the radiating pain and numbness / tingling down her L arm that has not gone away with anything.
Reports significant pain in elbow radiating to lower arm at night.
Further workup is still pending.