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 1376042



Case Details

VAERS ID: 1376042 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-06-03
Onset:2021-06-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 038C21A / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Dyspnoea, Gait disturbance, Headache, Impaired driving ability, Impaired work ability, Mental impairment
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Dementia (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: None
Preexisting Conditions: History of Hypertension
Allergies: Morphine and Tramadol
Diagnostic Lab Data: None
CDC Split Type:

Write-up: 6/4/2021 1730 Pt called and stated that he felt fine the day of the 2nd Moderna vaccine, but when he woke up early the next morning, he experienced dizziness and his gait was unsteady. He went to work and began to feel worse. His co-workers noticed that he was not completing his paperwork correctly and he struggled doing his daily tasks. He stated he felt like he was going to pass out and was out of breath. His supervisor sent him home. He attempted to drive home and swerved off the road. He parked his car and got a ride home. He slept for several hours. He stated he is feeling better this evening. Now he has a headache, but does not have dizziness, unsteady gait, or feeling like he will pass out. I advised him that headache is a possible side effect of the vaccine, but the other symptoms are uncommon. I asked him to seek medical attention if the symptoms come back. He voiced understanding.


New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1376042


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