VAERS ID: 1294829

AGE: 40| SEX: F|STATE: OH (United States)

Description

Passed out; Right arm became norm down to her fingers; No longer move right arm from elbow down to fingers / lost functioning completely in the entire right arm; Terrible pain in the entire right arm; Heart rate dropped; Vomited; This spontaneous case was reported by an other health care professional (subsequently medically confirmed) and describes the occurrence of LOSS OF CONSCIOUSNESS (Passed out) in a 40-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 039K20A and 031L20A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No medical history was reported. Concomitant products included LEVOCETIRIZINE DIHYDROCHLORIDE (XYZAL) for an unknown indication. On 04-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 06-Feb-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 05-Jan-2021, the patient experienced LOSS OF CONSCIOUSNESS (Passed out) (seriousness criterion medically significant), HYPOAESTHESIA (Right arm became norm down to her fingers), HYPOKINESIA (No longer move right arm from elbow down to fingers / lost functioning completely in the entire right arm), PAIN IN EXTREMITY (Terrible pain in the entire right arm), HEART RATE DECREASED (Heart rate dropped) and VOMITING (Vomited). At the time of the report, LOSS OF CONSCIOUSNESS (Passed out), HYPOAESTHESIA (Right arm became norm down to her fingers), HYPOKINESIA (No longer move right arm from elbow down to fingers / lost functioning completely in the entire right arm), PAIN IN EXTREMITY (Terrible pain in the entire right arm), HEART RATE DECREASED (Heart rate dropped) and VOMITING (Vomited) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, Electromyogram: unknown (Inconclusive) result unknown. On an unknown date, Heart rate: low (Low) Drop in heart rate was reported. On an unknown date, Spinal X-ray: normal (normal) Reported to be normal. mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) dosing remained unchanged. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. Treatment details included the use of ibuprofen and oral steroid prednisone. A week later the patient's arm was still very painful and some functioning had returned but not up to 50%. Company comment: Based on the current available information and temporal association between the use of the product and the start date of the event, a causal relationship cannot be excluded. This case was linked to MOD21-083933 (E2B Linked Report).; Sender's Comments: Based on the current available information and temporal association between the use of the product and the start date of the event, a causal relationship cannot be excluded. MOD21-083933:2nd dose

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Symptoms

Hypokinesia, Vomiting, Hypoaesthesia, Pain in extremity, Loss of consciousness, Heart rate decreased, Electromyogram, Heart rate, Spinal X-ray

Vaccines

VAX DATE: 01-04-2021| ONSET DATE: 01-05-2021| DAYS TO ONSET: 1
NameDose #TypeManufacturerLotRouteSite
COVID19 (COVID19 (MODERNA)) 2 COVID19 MODERNA 039k20a OT RA

RECVDATE:05-07-2021
RPT_DATE:
CAGE_YR:39
CAGE_MO:
DIED:U
DATEDIED:
L_THREAT:U
ER_VISIT:
HOSPITAL:U
HOSPDAYS:
X_STAY:U
DISABLE:U
RECOVD:U
LAB_DATA:Test Name: EMG; Test Result: Inconclusive ; Result Unstructured Data: result unknown; Test Name: Heart rate; Result Unstructured Data: Drop in heart rate was reported; Test Name: Neck X-ray; Result Unstructured Data: Reported to be normal
V_ADMINBY:
OTHER_MEDS:XYZAL
CUR_ILL:
HISTORY:Comments: No medical history was reported.
PRIOR_VAX:
SPLTTYPE:USMODERNATX, INC.MOD20210
FORM_VERS:
TODAYS_DATE:05-07-2021
BIRTH_DEFECT:U
OFC_VISIT:U
ER_ED_VISIT:U
ALLERGIES:
V_FUNDBY:

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