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This is VAERS ID 1043738

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History of Changes from the VAERS Wayback Machine

First Appeared on 6/4/2021

VAERS ID: 1043738
VAERS Form:2
Age:30.0
Sex:Male
Location:California
Vaccinated:2021-02-19
Onset:2021-02-20
Submitted:0000-00-00
Entered:2021-02-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 RA / SYR

Administered by: Private      Purchased by: ??
Symptoms: Chest pain, Chest X-ray, Electrocardiogram, Heart rate increased, Palpitations, Thrombosis

Life Threatening? No
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)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Centrum multivitamin Oxcarbazepine 300mg 2x daily Buspirone 15mg as needed
Current Illness: None known
Preexisting Conditions: None
Allergies: None known
Diagnostic Lab Data: Blood clot, EKG, and chest heart Xray at Emergency room.
CDC 'Split Type':

Write-up: Heart palpitations. Fast heart beat. 99-120. 95 when at rest. Up to 130 when stabding or moving from laying position. Chest pain heart area.

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