VAERS ID: 2013702

AGE: 16| SEX: F|STATE: FR (Unknown)

Description

FEVER & FACIAL ASYMMETRY; FEVER & FACIAL ASYMMETRY; This case was received via an unknown source (no reference has been entered for a health authority or license partner) on 23-Dec-2021 and was forwarded to Moderna on 24-Dec-2021. This regulatory authority case was reported by a consumer and describes the occurrence of PYREXIA (FEVER & FACIAL ASYMMETRY) and FACIAL ASYMMETRY (FEVER & FACIAL ASYMMETRY) in a 16-year-old female patient who received mRNA-1273 (COVID-19 Vaccine Moderna) (batch no. 939918) for an unknown indication. No Medical History information was reported. On 01-Dec-2021, the patient received dose of mRNA-1273 (COVID-19 Vaccine Moderna) (Intramuscular) 1 dosage form. On 01-Dec-2021 at 9:00 AM, the patient experienced PYREXIA (FEVER & FACIAL ASYMMETRY) (seriousness criterion hospitalization prolonged) and FACIAL ASYMMETRY (FEVER & FACIAL ASYMMETRY) (seriousness criterion hospitalization prolonged). At the time of the report, PYREXIA (FEVER & FACIAL ASYMMETRY) and FACIAL ASYMMETRY (FEVER & FACIAL ASYMMETRY) outcome was unknown. Not Provided The action taken with mRNA-1273 (COVID-19 Vaccine Moderna) (Intramuscular) was unknown. No concomitant medication was provided by reporter. No treatment drug was provided by reporter. Company Comment - This case concerns a 16 year old female patient with no relevant medical history, who experienced the serious (hospitalization) unexpected events of pyrexia and facial asymmetry. The events occurred on the same day after a dose of mRNA-1273 vaccine. The rechallenge was unknown. The benefit-risk relationship of the mRNA-1273 vaccine is not affected by this report.; Sender's Comments: This case concerns a 16 year old female patient with no relevant medical history, who experienced the serious (hospitalization) unexpected events of pyrexia and facial asymmetry. The events occurred on the same day after a dose of mRNA-1273 vaccine. The rechallenge was unknown. The benefit-risk relationship of the mRNA-1273 vaccine is not affected by this report.

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Symptoms

Pyrexia, Facial asymmetry

Vaccines

VAX DATE: 12-01-2021| ONSET DATE: 12-01-2021| DAYS TO ONSET: 0
NameDose #TypeManufacturerLotRouteSite
COVID19 (COVID19 (MODERNA)) 0 COVID19 MODERNA 939918 OT

RECVDATE:01-07-2022
RPT_DATE:
CAGE_YR:
CAGE_MO:
DIED:U
DATEDIED:
L_THREAT:U
ER_VISIT:
HOSPITAL:U
HOSPDAYS:
X_STAY:Y
DISABLE:U
RECOVD:U
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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OpenVAERS is a private organization that posts publicly available CDC/FDA data of injuries reported post-vaccination. Reports are not proof of causality.