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|History of Changes from the VAERS Wayback Machine|
|Vaccination / Manufacturer||Lot / Dose||Site / Route|
|COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA||054C21A / 1||LA / IM|
Administered by: Pharmacy Purchased by: ??
Symptoms: Dizziness, Fall, Hypotension, Pallor, Syncope, Visual impairment
Life Threatening? No
Birth Defect? No
Permanent Disability? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Diagnostic Lab Data:
CDC 'Split Type':
Write-up: Systemic: Dizziness / Lightheadness-Mild, Systemic: Fainting / Unresponsive-Mild, Systemic: Hypotension-Mild, Systemic: Visual Changes/Disturbances-Mild, Additional Details: patient had some dizziness, pale color, fell out of chair and on to floor after receiving shot. patient was alert and responsive, sat down again and held on to counter for about 30 minutes. patient stated he no longer felt dizzy or strange. I took patient''s BP and it was 99/58 with HR of 55 bpm, patient stated he is very fit and this was normal for him. I allowed patient to leave at that point, contacted him on 6/22, he said he was well and had experienced no additional issues after leaving.
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