VAERS ID: 2013701

AGE: 13| SEX: F|STATE: FR (Unknown)

Description

Chest pain; Difficulty breathing; Palpitations; Hyperventilation; This regulatory authority case was reported by an other health care professional and describes the occurrence of CHEST PAIN (Chest pain), DYSPNOEA (Difficulty breathing), PALPITATIONS (Palpitations) and HYPERVENTILATION (Hyperventilation) in a 13-year-old female patient who received mRNA-1273 (COVID-19 Vaccine Moderna) (batch no. 083F21B) for an unknown indication. No Medical History information was reported. On 30-Nov-2021, the patient received dose of mRNA-1273 (COVID-19 Vaccine Moderna) (Intramuscular) 1 dosage form. On 30-Nov-2021 at 2:00 PM, the patient experienced CHEST PAIN (Chest pain) (seriousness criterion hospitalization prolonged), DYSPNOEA (Difficulty breathing) (seriousness criterion hospitalization prolonged), PALPITATIONS (Palpitations) (seriousness criterion hospitalization prolonged) and HYPERVENTILATION (Hyperventilation) (seriousness criterion hospitalization prolonged). At the time of the report, CHEST PAIN (Chest pain), DYSPNOEA (Difficulty breathing), PALPITATIONS (Palpitations) and HYPERVENTILATION (Hyperventilation) was resolving. The action taken with mRNA-1273 (COVID-19 Vaccine Moderna) (Intramuscular) was unknown. For mRNA-1273 (COVID-19 Vaccine Moderna) (Intramuscular), the reporter did not provide any causality assessments. The patient was admitted in Hospital last 30-Nov-2021 due to paleness, cold extremities, chest pain, difficulty of breathing and hyperventilation. She was vaccinated with the first dose of the Moderna COVID-19 vaccine in the Left deltoid last 30-Nov-2021 in gymnasium during the 3-day National Vaccination activity. No concomitant medications were provided. No treatment medications were provided. Company Comment: This regulatory case concerns a 13-year-old, female patient with no medical history reported, who experienced the unexpected, serious events of chest pain, dyspnoea, palpitations and hyperventilation. The events, which resulted in hospitalization, occurred on the same day after administration of the first dose of the Moderna mRNA-1273 vaccine. Treatment information was not provided. However, the events were resolving at the time of the report. The rechallenge was not applicable as the events occurred after the first dose. The benefit-risk relationship of the Moderna mRNA-1273 vaccine is not affected by this report.; Sender's Comments: This regulatory case concerns a 13-year-old, female patient with no medical history reported, who experienced the unexpected, serious events of chest pain, dyspnoea, palpitations and hyperventilation. The events, which resulted in hospitalization, occurred on the same day after administration of the first dose of the Moderna mRNA-1273 vaccine. Treatment information was not provided. However, the events were resolving at the time of the report. The rechallenge was not applicable as the events occurred after the first dose. The benefit-risk relationship of the Moderna mRNA-1273 vaccine is not affected by this report.

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Symptoms

Dyspnoea, Palpitations, Hyperventilation, Chest pain

Vaccines

VAX DATE: 11-30-2021| ONSET DATE: 11-30-2021| DAYS TO ONSET: 0
NameDose #TypeManufacturerLotRouteSite
COVID19 (COVID19 (MODERNA)) 0 COVID19 MODERNA 083F21B OT Unknown

RECVDATE:01-07-2022
RPT_DATE:
CAGE_YR:
CAGE_MO:
DIED:U
DATEDIED:
L_THREAT:U
ER_VISIT:
HOSPITAL:Y
HOSPDAYS:
X_STAY:U
DISABLE:U
RECOVD:N
LAB_DATA:
V_ADMINBY:
OTHER_MEDS:
CUR_ILL:
HISTORY:
PRIOR_VAX:
SPLTTYPE:PHMODERNATX, INC.MOD20214
FORM_VERS:
TODAYS_DATE:01-05-2022
BIRTH_DEFECT:U
OFC_VISIT:U
ER_ED_VISIT:U
ALLERGIES:
V_FUNDBY:

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