VAERS ID: 1930989

AGE: 31| SEX: F|STATE: FR (Unknown)

Description

Cardiac arrest; Septic shock; Hypovolemic shock; Hypovolemic shock; Hypoxic encephalopathy; Acute kidney injury; Metabolic acidosis; This case was received via Agency Regulatory Authority (Reference number: PH-PHFDA-300120200) on 25-Nov-2021 and was forwarded to Moderna on 25-Nov-2021. This regulatory authority prospective pregnancy case was reported by an other health care professional and describes the occurrence of CARDIAC ARREST (Cardiac arrest), SEPTIC SHOCK (Septic shock), the first episode of HYPOVOLAEMIC SHOCK (Hypovolemic shock), the second episode of HYPOVOLAEMIC SHOCK (Hypovolemic shock), HYPOXIC-ISCHAEMIC ENCEPHALOPATHY (Hypoxic encephalopathy), ACUTE KIDNEY INJURY (Acute kidney injury) and METABOLIC ACIDOSIS (Metabolic acidosis) in a 31-year-old female patient (gravida 2, para 1) who received mRNA-1273 (COVID-19 Vaccine Moderna) (batch no. 083F21B) for COVID-19 vaccination. No Medical History information was reported. On 05-Nov-2021, the patient received dose of mRNA-1273 (COVID-19 Vaccine Moderna) (Intramuscular) 1 dosage form. Last menstrual period and estimated date of delivery were not provided. On an unknown date, the patient experienced CARDIAC ARREST (Cardiac arrest) (seriousness criteria death and medically significant), SEPTIC SHOCK (Septic shock) (seriousness criteria death and medically significant), the first episode of HYPOVOLAEMIC SHOCK (Hypovolemic shock) (seriousness criteria death and medically significant), the second episode of HYPOVOLAEMIC SHOCK (Hypovolemic shock) (seriousness criteria death and medically significant), HYPOXIC-ISCHAEMIC ENCEPHALOPATHY (Hypoxic encephalopathy) (seriousness criteria death and medically significant), ACUTE KIDNEY INJURY (Acute kidney injury) (seriousness criteria death and medically significant) and METABOLIC ACIDOSIS (Metabolic acidosis) (seriousness criterion death). The reported cause of death was Cardiac arrest, Septic shock, Hypovolaemic shock, Hypoxic-ischaemic encephalopathy, Acute kidney injury and Metabolic acidosis. It is unknown if an autopsy was performed. For mRNA-1273 (COVID-19 Vaccine Moderna) (Intramuscular), the reporter did not provide any causality assessments. No concomitant and treatment medication were provided G2P1 patient , pregnancy uterine 34 weeks AOG by LMP, Cephalic in labor was provided Company Comment : This is a regulatory case concerning a 31 year-old, female patient with no relevant medical history, who experienced the Fatal unexpected, according Agency, AESI of Hypoxic-ischaemic encephalopathy and Acute kidney injury; and the Fatal unexpected, according Agency, events of Cardiac arrest, Septic shock, Hypovolaemic shock (reported twice) and Metabolic acidosis. Additionally, the patient was 34 weeks pregnant and in cephalic labour, no dates and fetal outcome were provided, probably a case of maternal exposure during pregnancy. The events occurred on an unknown date after the mRNA-1273 vaccine, dose number not provided. The patient died on an unknown date, it is unknown if an autopsy was performed. The rechallenge was not applicable due to the fatal outcome. The benefit-risk relationship of mRNA-1273 vaccine is not affected by this report.; Sender's Comments: This is a regulatory case concerning a 31 year-old, female patient with no relevant medical history, who experienced the Fatal unexpected, according Agency, AESI of Hypoxic-ischaemic encephalopathy and Acute kidney injury; and the Fatal unexpected, according Agency, events of Cardiac arrest, Septic shock, Hypovolaemic shock (reported twice) and Metabolic acidosis. Additionally, the patient was 34 weeks pregnant and in cephalic labour, no dates and fetal outcome were provided, probably a case of maternal exposure during pregnancy. The events occurred on an unknown date after the mRNA-1273 vaccine, dose number not provided. The patient died on an unknown date, it is unknown if an autopsy was performed. The rechallenge was not applicable due to the fatal outcome. The benefit-risk relationship of mRNA-1273 vaccine is not affected by this report.; Reported Cause(s) of Death: Cardiac arrest; Septic shock; Hypovolaemic shock; Hypoxic-ischaemic encephalopathy; Acute kidney injury; Metabolic acidosis

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Symptoms

Cardiac arrest, Metabolic acidosis, Septic shock, Hypovolaemic shock, Hypoxic-ischaemic encephalopathy, Acute kidney injury

Vaccines

VAX DATE: 11-05-2021| ONSET DATE: | DAYS TO ONSET:
NameDose #TypeManufacturerLotRouteSite
COVID19 (COVID19 (MODERNA)) 0 COVID19 MODERNA 083F21B OT

RECVDATE:12-08-2021
RPT_DATE:
CAGE_YR:
CAGE_MO:
DIED:Y
DATEDIED:
L_THREAT:U
ER_VISIT:
HOSPITAL:U
HOSPDAYS:
X_STAY:U
DISABLE:U
RECOVD:N
LAB_DATA:
V_ADMINBY:
OTHER_MEDS:
CUR_ILL:
HISTORY:
PRIOR_VAX:
SPLTTYPE:PHMODERNATX, INC.MOD20213
FORM_VERS:
TODAYS_DATE:12-07-2021
BIRTH_DEFECT:U
OFC_VISIT:U
ER_ED_VISIT:U
ALLERGIES:
V_FUNDBY:

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