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 1394863



Case Details

VAERS ID: 1394863 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Male  
Location: Tennessee  
Vaccinated:2021-05-22
Onset:2021-06-03
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 2021-06-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 021B21A / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood test, Electrocardiogram, Magnetic resonance imaging, Nausea, Vertigo positional, Vomiting
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Zyrtec, Singulair
Current Illness: None
Preexisting Conditions: None
Allergies: Raw carrots, raw celery, seasonal allergies
Diagnostic Lab Data: Blood test, EKG, MRI.
CDC Split Type:

Write-up: Benign paroxysmal vertigo. Nausea with vomiting.


New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1394863


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