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From the 9/10/2021 release of VAERS data:

This is VAERS ID 1446900



Case Details

VAERS ID: 1446900 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-06-14
Onset:2021-06-29
   Days after vaccination:15
Submitted: 0000-00-00
Entered: 2021-07-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Blood luteinising hormone abnormal, Cerebrovascular accident, Computerised tomogram head normal, Diastolic dysfunction, Echocardiogram normal, Ejection fraction normal, Electrocardiogram ambulatory, Full blood count normal, Glycosylated haemoglobin normal, Hemiparesis, Magnetic resonance imaging head abnormal, Metabolic function test normal, Troponin normal, Ultrasound Doppler normal, Visual impairment, Wall motion score index normal
SMQs:, Cardiac failure (broad), Anticholinergic syndrome (broad), Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Glaucoma (broad), Optic nerve disorders (broad), Cardiomyopathy (broad), Lens disorders (broad), Retinal disorders (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: obesity
Allergies: nkda
Diagnostic Lab Data: CT of the head was unremarkable but MRI revealed foci of restricted diffusion within the right occipital lobe concerning for acute infarct/ischemia as well as old right basal ganglia infarct CBC, CMP, and troponin unremarkable Hemoglobin A1c 5.9 Carotid Dopplers without hemodynamically significant stenosis Echocardiogram with grade 1 diastolic dysfunction with normal ejection fracture, no regional wall motion abnormalities, and a negative bubble study. Holter pending
CDC Split Type:

Write-up: cva with left sided weakness, LH and vision changes


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