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|History of Changes from the VAERS Wayback Machine|
|Vaccination / Manufacturer||Lot / Dose||Site / Route|
|COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA||011D21A / 1||LA / IM|
Administered by: Pharmacy Purchased by: ??
Symptoms: Asthenia, Confusional state, Dizziness, Flushing, Hyperhidrosis, Nausea, Syncope, Tremor, Unresponsive to stimuli, Vomiting
Life Threatening? No
Birth Defect? No
Permanent Disability? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Diagnostic Lab Data:
CDC 'Split Type':
Write-up: Systemic: Confusion-Mild, Systemic: Dizziness / Lightheadness-Severe, Systemic: Fainting / Unresponsive-Severe, Systemic: Flushed / Sweating-Severe, Systemic: Nausea-Severe, Systemic: Shakiness-Severe, Systemic: Vomiting-Severe, Systemic: Weakness-Severe, Additional Details: Patient approached pharmacy and appeared normal/healthy. Vaccine was mixed/prepared/given proper protocol. Patient sat down after vaccination and within 5-10 minutes he fainted face forward from a seated position. He regained consciousness within 30 seconds of fainting. He then vomited within minutes after he sat up after fainting. A nurse practitioner was in store shopping and stopped by to read his blood pressure (135/76) then the EMT arrived within a minute of the blood pressure reading.
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