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

This is VAERS ID 1437466



Case Details

VAERS ID: 1437466 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-06-26
Onset:2021-06-30
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-06-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 003C21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dysphagia, Facial paralysis, Tenderness
SMQs:, Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Hearing impairment (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: HBP, DYSLIPIDEMIA
Allergies: NKDA
Diagnostic Lab Data:
CDC Split Type:

Write-up: PT CALLED SAYING SYMPTOMS STARTED TODAY 6/30: DROOPING ON ONE SIDE OF FACE, REPORTS TENDERNESS, TROUBLE SWALLOWING; DENIES TROUBLE BREATHING OR SIGNIFICANT PAIN IN AREA. EXPLAINED IT MAY BE BELLS PALSY. PT WILL BE GOING TO ER TO BE FURTHER EVALULATED.


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