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From the 7/23/2021 release of VAERS data:

This is VAERS ID 1129176



Case Details

VAERS ID: 1129176 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-02-06
Onset:2021-02-07
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-03-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 028L20A / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Cerebral infarction, Computerised tomogram, Echocardiogram, Magnetic resonance imaging, Scan with contrast, Visual field defect
SMQs:, Ischaemic central nervous system vascular conditions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Noninfectious encephalitis (broad), Optic nerve disorders (broad), Retinal disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Lisinopril: 20mg daily Metoprolol: 25mg daily Aspirin: 81mg daily Fluticasone Propionate: 50mcg 1 spray in each nostril daily Atorvastatin (Lipitor): 20mg daily Xarelto: 20mg daily Multivitamin: daily Vitamin B12: 1000mcg daily
Current Illness:
Preexisting Conditions:
Allergies: Penicillin
Diagnostic Lab Data: CT scan w/o contrast - 2/9/2021 CT scan with contrast - 2/9/2021 TEE - 2/11/2021 MRI - 2/11/2021
CDC Split Type:

Write-up: Within 12 hours of receiving the 2nd dose of the Moderna vaccine, I experienced an occipital cerebral infarction in the left occipital lobe. As a result, I have a loss of peripheral vision in the right upper quadrant.


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