이상반응 보고
| VAERS ID | 1627093 |
|---|---|
| 성별 | 여성 |
| 나이 | 16세 |
| 주 코드 | MO |
| 제약회사 | MODERNA |
| 로트 번호 | 031B21A |
| 예방접종 횟수 | 1 |
| 접종일 | 2021-06-09 |
| 발병일 | 2021-06-09 |
| 상태 |
증상
- 부적절한 연령의 환자에게 투여된 제품(Product administered to patient of inappropriate age)
- 오프 라벨 사용(Off label use)
이환 중 질병
Hearing reduced; Obesity
지병
Medical History/Concurrent Conditions: Penicillin allergy
기타 의료
DEPO-PROVERA
이전 예방접종
알레르기
임상 검사
증상 상세
vaccine administered to a sixteen year old; Off label use in unapproved age group; This spontaneous case was reported by a nurse and describes the occurrence of PRODUCT ADMINISTERED TO PATIENT OF INAPPROPRIATE AGE (vaccine administered to a sixteen year old) and OFF LABEL USE (Off label use in unapproved age group) in a 16-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no.
031b21a) for COVID-19 vaccination.
Concurrent medical conditions included Hearing reduced since 23-Jun-2021, Obesity since 23-Jun-2021 and Penicillin allergy.
Concomitant products included MEDROXYPROGESTERONE ACETATE (DEPO-PROVERA) from 23-Jun-2021 to an unknown date for Contraception.
On 09-Jun-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form.
On 09-Jun-2021, the patient experienced PRODUCT ADMINISTERED TO PATIENT OF INAPPROPRIATE AGE (vaccine administered to a sixteen year old) and OFF LABEL USE (Off label use in unapproved age group).
At the time of the report, PRODUCT ADMINISTERED TO PATIENT OF INAPPROPRIATE AGE (vaccine administered to a sixteen year old) and OFF LABEL USE (Off label use in unapproved age group) outcome was unknown.
The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown.
For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments.
Patient received a Moderna vaccine that was not age-indicated.
Patient did not experience any adverse event at any time.
No treatment information was provided.
Most recent FOLLOW-UP information incorporated above includes: On 29-Jul-2021: added reporter details.
added current conditions.
added concomitants.
added no adrs after receiving vaccine.