Sex: F
Vaccine: COVID19
Symptoms: Skin necrosis, White blood cell count, Wound secretion
Clinical narrative: Skin necrosis; Severe dermatitis; Left side macerated with stuff all over it; Bilateral axillary pain that got worse and worse; Left side-patient reported that it was draining; Bilateral axillary swelling that got worse and worse; A spontaneous report was received from a physician concerning a 34-year-old, female patient, who received Moderna's COVID-19 vaccine (mRNA-1273) and experienced severe dermatitis, skin necrosis, bilateral axillary pain that got worse and worse, bilateral axillary swelling that got worse and worse, left side macerated with stuff all over it and left side-patient reported that it was draining.   The patient's medical history was not provided. No relevant concomitant medications were reported.   On 05 Jan 2021, prior to the onset of the events, the patient received their first of two planned doses of mRNA-1273 intramuscularly in the left arm for prophylaxis of COVID-19 infection.   On unknown date, the patient developed systemic reactions for a couple days with bilateral axillary swelling and pain that got worse and worse. She developed severe dermatitis with skin necrosis.  On 10 Jan 2021, the patient went to urgent care and was given methylprednisolone 50 mg for four days. Her left side especially was swelling and was macerated with stuff all over it. The patient reported that it was draining also. A computerized axial tomography (CAT) scan did not show any abscess; it showed several lymph nodes on left axilla with the largest being 1.5 centimeters (CM), nothing impressive and nothing that explains skin necrosis. Her white blood cell count (WBC) was 18 (units and reference ranges were not provided) and vital signs were stable with no fever. On exam, the only thing the doctor found was a small lymph node in the right axillary area, and the left axillary area was significantly more swollen. The injection site on the left arm has nothing.    On unknown date, the patient was at the hospital and given antibiotics and methylprednisolone.  Action taken with mRNA-1273 in response to the events was not reported.   The outcome of the events, severe dermatitis, skin necrosis, bilateral axillary pain that got worse and worse, bilateral axillary swelling that got worse and worse, left side macerated with stuff all over it and left side-patient reported that it was draining, were not reported.; Reporter's Comments: This case concerns a 34-year-old, female patient, who experienced a serious unexpected event of skin necrosis, non-serious unexpected event of dermatitis, skin maceration, axillary pain, wound secretion, and non-serious expected event of lymphadenopathy. The events occurred on an unspecified date after first dose of mRNA-1273, lot # unknown.  Laboratory tests revealed WBC 18 and a CT scan showed several lymph nodes on left axilla with no abscess. Treatment included antibiotics and Medrol. Very limited information regarding these events has been provided at this time.  Based on the current available information and temporal association between the use of the product and onset of the event a causal relationship cannot be excluded.