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This is VAERS ID 1440583

History of Changes from the VAERS Wayback Machine

First Appeared on 7/2/2021

VAERS ID: 1440583
VAERS Form:2
Age:49.0
Sex:Male
Location:Texas
Vaccinated:2021-06-29
Onset:2021-06-29
Submitted:0000-00-00
Entered:2021-07-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Back pain, Blood pressure increased, Cardiac arrest, Chest discomfort, Injection site pain, Pyrexia, Axillary pain, Cardiac discomfort

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? Yes
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: vitamin D, fish oil 1000mg, CoQ10 Metaformin 2g, Atorvastatin 20 mg, Alopurinol 50 mg, Amlodipine 5 mg
Current Illness: None
Preexisting Conditions: High blood pressure, high cholesterol, gout
Allergies: None
Diagnostic Lab Data: Will see family doctor tomorrow morning (8:30am on 7/2/2021).
CDC 'Split Type':

Write-up: 1. Significant discomfort around the left chest, heart area. Feel null and pain around the armpit, upper left arm and left back area. The discomfort and pain reached peak a day after the 2nd shot. When writing this report, 48 hours have passed. The discomfort is not completed gone. 2. Accelerated heart beat rate (90-100 a minute) for 2 nights, with 38.5 deg C fever. 3. Elevated blood pressure (135/95).

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