National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts.org
Search Results

From the 1/7/2022 release of VAERS data:

This is VAERS ID 1052774

Government Disclaimer on use of this data



Case Details

VAERS ID: 1052774 (history)  
Form: Version 2.0  
Age: 85.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-02-22
Onset:2021-02-22
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-02-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Cerebral infarction, Facial paralysis, Hemiparesis, Ischaemic stroke, Magnetic resonance imaging brain abnormal, Speech disorder
SMQs:, Ischaemic central nervous system vascular conditions (narrow), Dementia (broad), Embolic and thrombotic events, arterial (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (narrow), Hearing impairment (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Amlodipine, calcium carbonate, cetirizine, vitamin D3, fish oil, latanoprost ophthalmic solution, losartan, metoprolol succinate, multivitamin, saline nasal spray, timolol 0.5% ophthalmic gel
Current Illness: Osteoporosis Hypertension DJD Glaucoma vasomotor rhinitis Paroxysmal supraventricular tachycardia History of mycobacterium avium lung infection/ colonization Prediabetes
Preexisting Conditions: Osteoporosis Hypertension DJD Glaucoma vasomotor rhinitis Paroxysmal supraventricular tachycardia History of mycobacterium avium lung infection/ colonization Prediabetes
Allergies: No known allergies
Diagnostic Lab Data: MRI of the brain wo contrast 2/24/21: 1. Moderate-sized acute to subacute right-sided MCA infarct as detailed above. 2. Tiny focus of acute subacute infarct within the cortex or subcortical white matter of the right occipital lobe in a posterior cerebral distribution which suggests a central embolic source versus extension through a posterior to communicating artery.
CDC Split Type:

Write-up: The patient has developed an acute ischemic stroke on the evening of receiving the COVID vaccine #1 dose. She is in the hospital with left sided weakness, facial droop and speech changes. She is receiving blood thinner and therapies.


New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1052774


Copyright © 2022 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166