VAERS ID: 2013703

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

Description

Seizure; 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 an other health care professional and describes the occurrence of SEIZURE (Seizure) in a 16-year-old female patient who received mRNA-1273 (COVID-19 Vaccine Moderna) (batch no. 086521A) for an unknown indication. No Medical History information was reported. On 03-Dec-2021, the patient received dose of mRNA-1273 (COVID-19 Vaccine Moderna) (Intramuscular) 1 dosage form. On 03-Dec-2021, the patient experienced SEIZURE (Seizure) (seriousness criterion medically significant). At the time of the report, SEIZURE (Seizure) had resolved. 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. No concomitant medications were reported. The treatment information was unknown; Sender's Comments: This is a regulatory case concerning a 16-year-old female patient with no medical history provided, who experienced the serious unexpected event of seizure (seriousness criterion medically significant). This event occurred on the same day the patient received the first dose of mRNA-1273 (COVID-19 Vaccine Moderna). The rechallenge was unknown since there's only information about the first dose. The benefit-risk relationship of mRNA-1273 Vaccine is not affected by this report. Event seriousness assessed as per Regulatory Authority reporting.

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Symptoms

Seizure

Vaccines

VAX DATE: 12-03-2021| ONSET DATE: 12-03-2021| DAYS TO ONSET: 0
NameDose #TypeManufacturerLotRouteSite
COVID19 (COVID19 (MODERNA)) 0 COVID19 MODERNA 086521A OT

RECVDATE:01-07-2022
RPT_DATE:
CAGE_YR:
CAGE_MO:
DIED:U
DATEDIED:
L_THREAT:U
ER_VISIT:
HOSPITAL:U
HOSPDAYS:
X_STAY:U
DISABLE:U
RECOVD:Y
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.