National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

From the 10/8/2021 release of VAERS data:

This is VAERS ID 1429923



Case Details

VAERS ID: 1429923 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-06-14
Onset:2021-06-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Dysstasia, Hallucination, auditory, Hypoaesthesia, Immediate post-injection reaction, Nausea, Pain, Pain in extremity, Peripheral coldness
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Dementia (broad), Psychosis and psychotic disorders (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Sexual dysfunction (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: Regular Medications: LevonorgestreL/ Mirena IUD Aspirin 81 mg EC tablet- 1 tablet once a day Cetirizine 10 mg tablet- 2 tablet twice a day Mometasone 200 mcg/actuation HFAA- 2 puffs twice a day Montelukast 10 mg tablet- 1 tab once per day V
Current Illness: n/a
Preexisting Conditions: Asthma, ADHD, PTSD, hypoglycemia, chronic low blood-pressure
Allergies: Cats; onion; pineapple; trees; grasses; weeds; SOME UKNOWN INGREDIENT IN THE FOLLOWING ITEMS: most make-up; marshmallows; all spray-can based foods (Ingredient is possibly some forms of potassium)
Diagnostic Lab Data: n/a
CDC Split Type:

Write-up: Arm immediately went numb; finger turned blue and became very cold to the touch; later that night ~6 hours after shot, I began to have very frightening auditory hallucinations for the first time in my life. I heard my dead cat screaming for me, and then later I heard my mother panicked and calling for me to help her (when I went to the opposite side of the house where she lives, she was fast asleep and had not called for me); the next two days I was shivering the entire day, barely able to stand, and incredibly nauseated. My arm also hurt to the point that moving it caused me to cry out in pain. There was no noticeable swelling at the sight at any point.


New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1429923

Government Disclaimer on use of this data


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