National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

From the 9/10/2021 release of VAERS data:

This is VAERS ID 1371559



Case Details

VAERS ID: 1371559 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-06-03
Onset:2021-06-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 038C21A / 2 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Muscle spasms, Muscle twitching, Seizure like phenomena, Unresponsive to stimuli
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Convulsions (narrow), Dyskinesia (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Tums, gabapentin, pravastatin, corianor, Vit D3, Dialyvite, Sacubitril/Valsartan, Coreg, Lantus, Phoslo, Trulicity
Current Illness: none
Preexisting Conditions: ESRD on dialysis
Allergies: Iodine, Morphine
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Pt received Moderna Covid-19 vaccine (second in series) at 1011, BP before vaccination 109/58, P/77. BP 20 minutes after vaccine was 93/57, P/60. At the end of pt''s tx, 1035, pt stated she was cramping and then became unresponsive with some seizure like activity, upper body twitching. O2 applied, NS given, pt became responsive, then had another seizure like episode, then again became responsive. BP 115/80, P/88 at this time. NP was on site. Due to the fact that the pt had the Covid vaccine and did not have a seizure history, NP ordered for EMS to be called (1038). Upon their arrival (1042) pt was A&O X 4, BP 150/88, P/65, T/ 97.0. Report given, care was transferred to EMS, belongings sent with pt. Pt requested to be taken to hospital.


New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1371559


Copyright © 2021 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166