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This is VAERS ID 1328950

History of Changes from the VAERS Wayback Machine

First Appeared on 5/28/2021

VAERS ID: 1328950
VAERS Form:2
Age:23.0
Sex:Male
Location:California
Vaccinated:2021-05-18
Onset:2021-05-18
Submitted:0000-00-00
Entered:2021-05-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 004C21A / 2 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Palpitations

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? Yes
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Rifampin
Current Illness: Heart murmur; latent tuberculosis, intermittent palpitations
Preexisting Conditions: Heart murmur; latent tuberculosis
Allergies: N/A
Diagnostic Lab Data: All same day: 1:25 162/73 pulse 121 1:35 151/70 pulse 93 1:48 150/82 pulse 76 1:42 136/75 pulse 77
CDC 'Split Type':

Write-up: patient experience palpitations after receiving Moderna #2.; Patient has underlying palpitations and getting work up by cardiology. 1:25 162/73 pulse 121 1:35 151/70 pulse 93 1:48 150/82 pulse 76 1:42 136/75 pulse 77 Patient improved after rest and drinking some water. Denied dizziness, chest pain and shortness of breath.General: calm, no acute distress. - possible adverse reaction vs his underlying palpitations. He is under care of cardiology and is getting work up for palpitations. Patient discharged at 2:05pm

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