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History of Changes from the VAERS Wayback Machine |
VAERS ID: | 2370120 |
VAERS Form: | 2 |
Age: | 0.5 |
Sex: | Male |
Location: | Maryland |
Vaccinated: | 2022-06-29 |
Onset: | 2022-06-30 |
Submitted: | 0000-00-00 |
Entered: | 2022-07-15 |
Vaccination / Manufacturer (1 vaccine) | Lot / Dose | Site / Route |
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA | AS1414B / UNK | - / OT |
Administered by: Unknown Purchased by: ??
Symptoms: Loss of consciousness, Respiratory arrest
Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: (blank)
Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': USMODERNATX, INC.MOD20226
Write-up: within 24hs of getting the Moderna covdi19 vaccine patient stopped breathing; within 24hs of getting the Moderna covdi19 vaccine patient went unconscious; This spontaneous case was reported by a patient family member or friend and describes the occurrence of RESPIRATORY ARREST (within 24hs of getting the Moderna covdi19 vaccine patient stopped breathing) and LOSS OF CONSCIOUSNESS (within 24hs of getting the Moderna covdi19 vaccine patient went unconscious) in a 6-month-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. AS1414B) for COVID-19 vaccination. No Medical History information was reported. On 29-Jun-2022, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 30-Jun-2022, the patient experienced RESPIRATORY ARREST (within 24hs of getting the Moderna covdi19 vaccine patient stopped breathing) (seriousness criteria hospitalization, medically significant and life threatening) and LOSS OF CONSCIOUSNESS (within 24hs of getting the Moderna covdi19 vaccine patient went unconscious) (seriousness criteria hospitalization and medically significant). The patient was hospitalized from sometime in 2022 to sometime in 2022 due to LOSS OF CONSCIOUSNESS and RESPIRATORY ARREST. At the time of the report, RESPIRATORY ARREST (within 24hs of getting the Moderna covdi19 vaccine patient stopped breathing) and LOSS OF CONSCIOUSNESS (within 24hs of getting the Moderna covdi19 vaccine patient went unconscious) was resolving. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medication was reported. No allergies were reported. Patient never had COVID positive test or diagnosis. No Medical history was reported by the reporter. It was reported that no other vaccines were given within 1 month prior to Moderna COVID-19 vaccine. No treatment information was provided. Company Comment: This spontaneous case concerns a 6-month-old, male patient with no medical history reported, who experienced the unexpected, serious (life-threatening, hospitalization and medically significant) event of respiratory arrest and the unexpected, serious (hospitalization and medically significant) event of loss of consciousness. The events occurred within 24 hours after receiving an unspecified dose of the mRNA-1273 vaccine. It was reported that the patient stopped breathing and went unconscious, and had to be hospitalized overnight. No further clinical information (including details about hospitalization, laboratory test/s and clinical course) was available for medical review. Treatment information was also not provided. It was reported that the symptoms had improved at the time of the report. The benefit-risk relationship of the mRNA-1273 vaccine is not affected by this report.; Sender''s Comments: This spontaneous case concerns a 6-month-old, male patient with no medical history reported, who experienced the unexpected, serious (life-threatening, hospitalization and medically significant) event of respiratory arrest and the unexpected, serious (hospitalization and medically significant) event of loss of consciousness. The events occurred within 24 hours after receiving an unspecified dose of the mRNA-1273 vaccine. It was reported that the patient stopped breathing and went unconscious, and had to be hospitalized overnight. No further clinical information (including details about hospitalization, laboratory test/s and clinical course) was available for medical review. Treatment information was also not provided. It was reported that the symptoms had improved at the time of the report. The benefit-risk relationship of the mRNA-1273 vaccine is not affected by this report.
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