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This is VAERS ID 1446271

History of Changes from the VAERS Wayback Machine

First Appeared on 7/9/2021

VAERS ID: 1446271
VAERS Form:2
Age:59.0
Sex:Male
Location:Colorado
Vaccinated:2021-06-25
Onset:2021-06-25
Submitted:0000-00-00
Entered:2021-07-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 039C21A / 1 RA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Blepharospasm, Dysgeusia, Hypoaesthesia, Vision blurred, Visual impairment

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? No
Previous Vaccinations:
Other Medications: 1. Lisinopril-HCTZ 20-12.5mg qd 2. Pantoprazole 40mg bid
Current Illness: None
Preexisting Conditions: 1. blood pressure 2. acid reflux
Allergies: 1. Soma -blotchy red spots
Diagnostic Lab Data: none
CDC 'Split Type':

Write-up: 1. Odd taste in mouth -metallic taste 5 minutes after the vaccine -still experiencing this symptom. No treatment has not call primary care provider. 2. Left eye started twitching and visual issues including blurry vision and seeing three images. Started 5 minutes after vaccine -still experiencing symptom. No treatment has not call primary care provider. 3. Left hand is numb, this started a couple days after the vaccine -not sure of date and is still experiencing this symptom. No treatment has not call primary care provider.

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