Age: 70.0
Sex: M
Vaccine: COVID19
Symptoms: Death
Clinical narrative: brother passed away of unknown circumstances on 04Jan2022; This spontaneous case was reported by a consumer and describes the occurrence of DEATH (brother passed away of unknown circumstances on 04Jan2022) in a 70-year-old male patient who received mRNA-1273 (Spikevax) for COVID-19 vaccination.     No Medical History information was reported.    On an unknown date, the patient received dose of mRNA-1273 (Spikevax) (unknown route) 1 dosage form. Death occurred on 04-Jan-2022 The patient died on 04-Jan-2022. The cause of death was not reported. It is unknown if an autopsy was performed.            No concomitant medications were provided by the reporter. No treatment information was provided by the reporter.  It was reported that patient was now deceased who was in a Moderna Covid-19 vaccine clinical study in 2020. The trial was conducted by the Medical Center. It was reported that the patient passed away due to unknown circumstances on 04Jan2022.  The patient received a placebo injection in the study.  After the trial ended, patient got unblinded and then received the Moderna Covid-19 vaccine. The reporter did not report any side effects or adverse reactions to Moderna Covid-19 vaccine. The reporter did not had dates of administration or lot numbers for the patient's Moderna Covid-19 vaccines. Deceased patient was listed as a contact in the case. On 05May2022 the reported answered the phone and said that he would try to call Moderna back with the information about vaccine lot numbers and dates of administration of the vaccine.  Company comment: This Spontaneous case concerns a 70-year-old male patient, with no reported medical history, who had a serious, unexpected fatal outcome unspecified day, after receiving a dose of mRNA-1273 vaccine.  Patient had passed away due to unknown circumstances and the cause of death was not reported.  It is unknown if an autopsy was performed.  The patient was reported to have been included in a clinical trial and have received a placebo injection while in the study.  After the trial ended, the patient received a dose of mRNA-1273 vaccine on unknown date.  Clinical course, circumstances surrounding the event and treatment details were not reported in this case. The benefit-risk relationship of mRNA-1273 is not affected by this report.   This case was linked to MOD-2022-56043.; Sender's Comments: This Spontaneous case concerns a 70-year-old male patient, with no reported medical history, who had a serious, unexpected fatal outcome unspecified day, after receiving a dose of mRNA-1273 vaccine.  Patient had passed away due to unknown circumstances and the cause of death was not reported.  It is unknown if an autopsy was performed.  The patient was reported to have been included in a clinical trial and have received a placebo injection while in the study.  After the trial ended, the patient received a dose of mRNA-1273 vaccine on unknown date.  Clinical course, circumstances surrounding the event and treatment details were not reported in this case. The benefit-risk relationship of mRNA-1273 is not affected by this report.; Reported Cause(s) of Death: his brother passed away of unknown circumstances