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This is VAERS ID 1454611

History of Changes from the VAERS Wayback Machine

First Appeared on 7/9/2021

VAERS ID: 1454611
VAERS Form:2
Age:19.0
Sex:Female
Location:Colorado
Vaccinated:2021-07-07
Onset:2021-07-07
Submitted:0000-00-00
Entered:2021-07-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 009D21A / 1 RA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Anxiety, Confusional state, Heart rate increased, Panic attack, Seizure, Eye movement disorder, Head titubation

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)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: asthma
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: 19 year old girl received the shot and was sitting out in front of the pharmacy. She had told me she was very anxious about getting it. Her mother screamed for us, so we rushed out and had a tech call ED. When we went out there, she was hunched over forward as her mother was holding her. She appeared to be having a seizure lasting around 10 seconds and was confused when she stopped. Her mother told us before that happened, her head fell back and her eyes were rolled back. Later, the patient told us she was just having a panic attack. The paramedics arrived and checked her out. All seemed to be fine, with the exception of a fast heartbeat as expected. They convinced her to go to the hospital to be checked out. I will follow-up with her mother this evening.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1454611&WAYBACKHISTORY=ON


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