National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

From the 6/4/2021 release of VAERS data:

This is VAERS ID 1231967



Case Details

VAERS ID: 1231967 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-04-10
Onset:2021-04-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 0371A21B / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthma, Dyspnoea
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Asthmanefrin cut with water, through a nebulizer
Current Illness: Mild occasional asthma. I also theorize I contracted Farmers Lung fall of 2020 from cleaning a storage bin of moldy soybeans.
Preexisting Conditions: Mild asthma for the past 50 years, No need to treat beyond Primatene Mist
Allergies: Farmer, pollens and grain dusts
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Asthma, Shortness of breath increased in severity by 4/15 or so. Has continued until present. I start to run out of breath when I reach the top of my stairs. I recover appx 3 min of rest. No increases in severity for the past 5 days. No fever, phlem, or mucus. Only breathlessness. Easier to sleep on an incline. (I must move too much in bed.)


New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1231967


Copyright © 2021 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166