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|History of Changes from the VAERS Wayback Machine|
|Vaccination / Manufacturer||Lot / Dose||Site / Route|
|COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA||007C21A / 1||LA / IM|
Administered by: Pharmacy Purchased by: ??
Symptoms: Asthenia, Chills, Dizziness, Fatigue, Flushing, Gait inability, Hyperhidrosis, Lethargy, Paraesthesia, Visual impairment, Hypoacusis, Impaired driving ability
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: Chills-Medium, Systemic: Dizziness / Lightheadness-Medium, Systemic: Exhaustion / Lethargy-Medium, Systemic: Flushed / Sweating-Medium, Systemic: Tingling (specify: facial area, extemities)-Medium, Systemic: Visual Changes/Disturbances-Medium, Systemic: Weakness-Medium, Additional Details: Within 5 minutes of receiving vaccine, patient alerted store personnel that he was "seeing stars" and have impaired hearing (sounds like underwater). Within 10 minutes, he started feeling chills and sweating; he reported feeling weak, unable to walk or drive and had tingling on his forearms. He was offered acetaminophen and Benadryl. He refused Benadryl but took on tablet of acetaminophen 500mg. At about 25 minutes post-injection, he reported feeling better and refused paramedics.
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