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|History of Changes from the VAERS Wayback Machine|
|Vaccination / Manufacturer||Lot / Dose||Site / Route|
|COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA||041C21A / 1||LA / IM|
Administered by: Pharmacy Purchased by: ??
Symptoms: Dyspnoea, Syncope, Unresponsive to stimuli, Fear of injection
Life Threatening? No
Birth Defect? No
Permanent Disability? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Diagnostic Lab Data:
CDC 'Split Type':
Write-up: Systemic: Allergic: Difficulty Breathing-Mild, Systemic: Fainting / Unresponsive-Severe, Additional Details: Patient stated was nervous around needles, but never fainted from a vaccine. Patient fainted twice in administration room, but recovered well afterwards. Patient stated difficulty breathing, but did not need an epipen as airway was not blocked. Water was given, she recovered well, and patient rested outside pharmacy for almost 1 hour. Patient left with no issues.
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