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This is VAERS ID 1371361

History of Changes from the VAERS Wayback Machine

First Appeared on 6/4/2021

VAERS ID: 1371361
VAERS Form:2
Age:59.0
Sex:Female
Location:Maryland
Vaccinated:2021-06-03
Onset:2021-06-03
Submitted:0000-00-00
Entered:2021-06-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 022C21A / 2 RA / IM

Administered by: Private      Purchased by: ??
Symptoms: Blood glucose normal, Dizziness, Hyperhidrosis, Pallor, Tremor, Unresponsive to stimuli, Musculoskeletal stiffness, Breath sounds abnormal, Seizure like phenomena

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: XANEX 0.25 ATORVASTATIN 20MG IBUPROFEN 600MG LEVOCETRIZINE 5MG LEVOTHYROXINE 25MCG LEXAPRO 5MG
Current Illness: NONE
Preexisting Conditions: HYPOTHYRIODISM HYPERLIPIDIMA DEPRESSION AND ANXIETY
Allergies: EPINEPHRINE HYDROMORPHONE
Diagnostic Lab Data: BP 1.ST-145/90, 2ND - 138/86
CDC 'Split Type':

Write-up: PT STARTED TO FEEL DIZZY, WHEN LAID BACK SHE STARTED TO HAVE SEIZURE LIKE ACTIVITY. LEGS AND ARMS SCHAKING, VERY STIFF, GARGLING NOISE FROM MOUTH, SWEATY, PALE, AND WASNT RESPONSIVE. 911 WAS CALLED AND DR. CAME IN ROOM TO ASSIST UNTIL EMS ARRIVED. SEIZURE LIKE ACTIVITY LASTED AROUND A MINUTE AND A HALF. ONCE PT CAME TO SHE WAS STILL UNABLE TO RESPOND TO ME FOR ANOTHER MINUTE AND THEN WHEN SHE COULD RESPOND SHE DIDNT HAVE ANY RECOLECTION OF WHAT HAD HAPPENED. PTS VITALS WERE MONITORED AND GLUCOSE WAS ALSO CHECKED, ALL WERE NORMAL. EMS ARRIVED AND TRANSPORTED PT TO NEAREST ER.

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