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VAERS Report 2156634

Case Report Section

Détails du rapport Vaer

Âge: 53 ans

Genre: Female

Région : Outside US

Patient décédé?
Non
Renseignements sur les vaccins

Nom: COVID19 (COVID19 (MODERNA))

Type : Coronavirus 2019 vaccine

Fabricant: MODERNA

Lot: 3004737


Date de réception du rapport
2022-03-04
Date à laquelle le formulaire est complèté
Date de vaccination
2021-12-01
Date d’apparition
6
Nombre de jours (date d’apparition – date de vaccination)
6
Description de l’événement indésirable

left leg pain from left buttock and left back of thigh, numbness in foot; left leg pain from left buttock and left back of thigh, numbness in foot; left leg pain from left buttock and left back of thigh, numbness in foot; this case was received via ra (reference number: gb-mhra-adr 26617841) on 23-feb-2022 and was forwarded to moderna on 23-feb-2022. this regulatory authority case was reported by a consumer and describes the occurrence of pain in extremity (left leg pain from left buttock and left back of thigh, numbness in foot), musculoskeletal pain (left leg pain from left buttock and left back of thigh, numbness in foot) and hypoaesthesia (left leg pain from left buttock and left back of thigh, numbness in foot) in a 53-year-old female patient who received mrna-1273 (moderna covid-19 vaccine) (batch no. 3004737) for covid-19 vaccination. patient is not currently breastfeeding. on 01-dec-2021, the patient received third dose of mrna-1273 (moderna covid-19 vaccine) (unknown route) 1 dosage form. on 07-dec-2021, the patient experienced pain in extremity (left leg pain from left buttock and left back of thigh, numbness in foot) (seriousness criteria disability and medically significant), musculoskeletal pain (left leg pain from left buttock and left back of thigh, numbness in foot) (seriousness criteria disability and medically significant) and hypoaesthesia (left leg pain from left buttock and left back of thigh, numbness in foot) (seriousness criteria disability and medically significant). at the time of the report, pain in extremity (left leg pain from left buttock and left back of thigh, numbness in foot), musculoskeletal pain (left leg pain from left buttock and left back of thigh, numbness in foot) and hypoaesthesia (left leg pain from left buttock and left back of thigh, numbness in foot) had not resolved. patient was not breastfeeding at the time of report. relevant concomitant medications were not reported. the dosage text for the suspect product was reported as dose 3c. treatment information was not provided. company comment: this regulatory case concerns a 53-year-old, female patient with no relevant medical history reported, who experienced the serious (seriousness criteria disability and medically significant) unexpected events of pain in extremity, musculoskeletal pain and hypoaesthesia. the events occurred 6 days after the third dose of mrna-1273. at the time of the report, the events had not resolved. the benefit-risk relationship of mrna-1273 is not affected by this report. event seriousness assessed as per regulatory authority reporting, however there was no information in the source document supporting that the events resulted in a persistent or permanent incapacity.; sender's comments: this regulatory case concerns a 53-year-old, female patient with no relevant medical history reported, who experienced the serious (seriousness criteria disability and medically significant) unexpected events of pain in extremity, musculoskeletal pain and hypoaesthesia. the events occurred 6 days after the third dose of mrna-1273. at the time of the report, the events had not resolved. the benefit-risk relationship of mrna-1273 is not affected by this report. event seriousness assessed as per regulatory authority reporting, however there was no information in the source document supporting that the events resulted in a persistent or permanent incapacity

Données de laboratoire
na
Liste des symptômes
pain in extremity hypoaesthesia musculoskeletal pain
Patient décédé?
Non
Date de décès
N/A
Anomalie congénitale
false
Vaccin administré par :
Unknown
Vaccin acheté par :
Inconnu
Visite d’un patient à l’urgence?
Non
Patient hospitalisé?
Non
Séjour à l’hôpital
Non
Nombre de jours à l’hôpital
Non spécifié
Invalidité permanente?
Oui
Allergies:
na
Maladie actuelle
na