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This is VAERS ID 1440799

History of Changes from the VAERS Wayback Machine

First Appeared on 7/2/2021

VAERS ID: 1440799
VAERS Form:2
Age:77.0
Sex:Male
Location:Missouri
Vaccinated:2021-03-23
Onset:2021-06-04
Submitted:0000-00-00
Entered:2021-07-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 044A21A / 2 LA / IM

Administered by: Public      Purchased by: ??
Symptoms: Echocardiogram normal, Hypoaesthesia, Infection, Computerised tomogram head normal, COVID-19, SARS-CoV-2 test positive, Magnetic resonance imaging head normal

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions: Type 2 Diabetes, Hypertension, Restless Leg Syndrome, Generalized anxiety disorder
Allergies: Unknown
Diagnostic Lab Data: COVID 19 Positive test - 6/4/2021 CT Scan of the head Negative - 6/4/2021 MRI Negative for acute stroke - 6/4/2021 Echocardiogram unremarkable - 6/4/2021
CDC 'Split Type':

Write-up: Breakthrough infection, includes hospital admission that appears unrelated to COVID 19. Patient reported to the hospital with right sided numbness of the face. Patient had an MRI that was negative for acute stroke.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1440799&WAYBACKHISTORY=ON

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