이상반응 보고
| VAERS ID | 1676968 |
|---|---|
| 성별 | 남성 |
| 나이 | 51세 |
| 주 코드 | FR |
| 제약회사 | MODERNA |
| 로트 번호 | |
| 예방접종 횟수 | 1 |
| 접종일 | 2021-07-03 |
| 발병일 | 2021-07-18 |
| 상태 | 사망 |
증상
- SARS-CoV-2 테스트(SARS-CoV-2 test)
- 관상 동맥 질환(Coronary artery disease)
- 신체 검사(Physical examination)
- 심근허혈(Myocardial ischaemia)
이환 중 질병
지병
기타 의료
이전 예방접종
알레르기
임상 검사
Test Name: COVID-19 PCR test; Test Result: Negative ; Result Unstructured Data: Negative; Test Name: Examination; Result Unstructured Data: No external trauma
증상 상세
Ischemic heart disease; Coronary heart disease with severe obstruction; This regulatory authority case was reported by an other health care professional and describes the occurrence of MYOCARDIAL ISCHAEMIA (Ischemic heart disease) and CORONARY ARTERY DISEASE (Coronary heart disease with severe obstruction) in a 51-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination.
No Medical History information was reported.
On 03-Jul-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form.
On 18-Jul-2021, the patient experienced MYOCARDIAL ISCHAEMIA (Ischemic heart disease) (seriousness criteria death and medically significant) and CORONARY ARTERY DISEASE (Coronary heart disease with severe obstruction) (seriousness criterion death).
The patient died on 18-Jul-2021.
An autopsy was performed.
The autopsy-determined cause of death was Ischemic heart disease and coronary heart disease with severe obstruction.
DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, Physical examination: no external trauma (normal) No external trauma.
On an unknown date, SARS-CoV-2 test: negative (Negative) Negative.
For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter considered MYOCARDIAL ISCHAEMIA (Ischemic heart disease) and CORONARY ARTERY DISEASE (Coronary heart disease with severe obstruction) to be possibly related.
It was reported that on 18-Jul-2021, patient was driving a commercial vehicle and lost consciousness suddenly at a red light and was found unresponsive and sent to hospital for emergency treatment.
Patient was Out-of-hospital cardiac arrest (OHCA) before reaching hospital and was dead.
No concomitant medication information was reported.
No treatment information was reported.
Company comment: This is a serious RA case from CDC.
The reaction / event as reported by the primary source is ¨other¨ .
As per autopsy result described in narrative of SD, the events Myocardial ischemia and Coronary artery disease, with fatal outcome are captured.
Based on the current available information and temporal association between the use of the product, and the start date of the events, a causal relationship cannot be excluded.
; Sender's Comments: This is a serious RA case from CDC.
The reaction / event as reported by the primary source is ¨other¨ .
As per autopsy result described in narrative of SD, the events Myocardial ischemia and Coronary artery disease, with fatal outcome are captured.
Based on the current available information and temporal association between the use of the product, and the start date of the events, a causal relationship cannot be excluded.
; Autopsy-determined Cause(s) of Death: Ischemic heart disease; Coronary heart disease with severe obstruction