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This is VAERS ID 1457620

History of Changes from the VAERS Wayback Machine

First Appeared on 7/9/2021

VAERS ID: 1457620
VAERS Form:2
Age:34.0
Sex:Male
Location:California
Vaccinated:2021-07-01
Onset:2021-07-03
Submitted:0000-00-00
Entered:2021-07-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 047B21A / 1 LA / IM

Administered by: Other      Purchased by: ??
Symptoms: Bell's palsy, Extraocular muscle paresis, Facial paralysis, Hypoaesthesia, Ophthalmoplegia, Facial paresis

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: nonr
Current Illness: none
Preexisting Conditions: none
Allergies: Fluconazole
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient states reporting numbness, weakness, with paralysis to the left side of the face and left eye. He states he first noticed his left eye not closing and drooping of the mouth when brushing his teeth on 07/03/2021. Patient was seen by a provider and was palced on medication and diagnosed with Bells Palsy.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1457620&WAYBACKHISTORY=ON


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