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This is VAERS ID 1375328

History of Changes from the VAERS Wayback Machine

First Appeared on 6/11/2021

VAERS ID: 1375328
VAERS Form:2
Age:38.0
Sex:Male
Location:Pennsylvania
Vaccinated:2021-06-01
Onset:2021-06-01
Submitted:0000-00-00
Entered:2021-06-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 050C21A / 2 RA / SYR

Administered by: Pharmacy      Purchased by: ??
Symptoms: Dyspnoea, Feeling abnormal, Panic attack

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)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Customer not a patient for rite aid. He says he is on diabetic medication and anxiety medicines.
Current Illness: unknown
Preexisting Conditions: diabetic and mood
Allergies: unknown
Diagnostic Lab Data: none
CDC 'Split Type':

Write-up: Pt experienced extreme panic attack right after vaccination. Contacted 911, and paramedics were dispatched from Delaware County Memorial Hospital. Pt alleges he "can''t breathe and don''t feel right. Never felt like this before." Epipen was really to be administered.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1375328&WAYBACKHISTORY=ON


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