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

This is VAERS ID 1333833



Case Details

VAERS ID: 1333833 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-05-04
Onset:2021-05-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 004C21A / 2 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Amnesia, Aphasia, Confusional state, Dialysis, Feeling hot, General physical condition abnormal, Intensive care, Life support, Memory impairment, Multi-organ disorder, Ocular hyperaemia, Pyrexia, Tremor
SMQs:, Acute renal failure (narrow), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Glaucoma (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Depression (excl suicide and self injury) (broad), Chronic kidney disease (narrow), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 8 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: no
Current Illness: no
Preexisting Conditions: no
Allergies: no
Diagnostic Lab Data: They do a lot of test every day
CDC Split Type:

Write-up: After vaccine by 6pm husband had high fever all night long, we woke up he took Tylenol and fever went down. He went out side for a little bit, his body temperature was still hot without chills and this lasted for 3 days and night. I talked to the pharmacist and he recommended Ibuprofen and I gave it to him for two days but he kept the fever. He started shaking and by the 5th day I took him to the clinic and both his eyes were red and hands and feet were hot. I was told to take him home because all vital signs were ok, but I took him back to the ER on day 8 because he was not getting better, they said he had multi organ issues and now he''s confused and he doesn''t know who I am or where he is and cannot remember and confused. He is now on dialysis and he was on life support, he was never hospitalized or taken prescription drugs and now he''s in this condition. He is still in ICU and his body looks so weird. He don''t remember words or when I talk to him.


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