National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

From the 9/3/2021 release of VAERS data:

This is VAERS ID 1377787



Case Details

VAERS ID: 1377787 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 036B21A / 2 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Blood pressure increased, Cardiac flutter, Chest discomfort, Oropharyngeal discomfort, Palpitations
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypertension (narrow), Cardiomyopathy (broad), Tachyarrhythmia terms, nonspecific (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Protonix
Current Illness: None
Preexisting Conditions: Migraines, GERD
Allergies: NKA
Diagnostic Lab Data:
CDC Split Type: N/A

Write-up: Patient reported palpitations, throats feels "funny", heart fluttering, heavy chest @ 9:19a. EMS called @ 9:22a. Diphenhydramine 12.5 mg PO administered @ 9:23a. Symptoms resolved in throat per patient @ 9:28a. Patients blood pressure was elevated at 9:20a at 154/111, pulse 85, O2 Sat 97% on outside air, respirations 16. EMS arrived at 9:32a. Patient not transported to hospital. EMS departed. Patients status when leaving was A+O x 4, clear speech, walking, all symptoms resolved.


New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1377787


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