Your Health. Your Family. Your Choice.
|History of Changes from the VAERS Wayback Machine|
|Vaccination / Manufacturer||Lot / Dose||Site / Route|
|COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA||EW0183 / 1||LA / IM|
Administered by: Public Purchased by: ??
Symptoms: Fall, Syncope, Skin laceration, Skin abrasion, Product administered to patient of inappropriate age
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
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: Vital signs: BP 100/80, Pulse 92, Resp 18, SaO2 98%. Staff recommends ambulance transport to Hospital, parents state will take patient to Urgent Care via personal vehicle.
CDC 'Split Type':
Write-up: Brief syncopal episode, fell from chair, struck head on floor, suffered small laceration and abrasion to left eyebrow.
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