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This is VAERS ID 1618485

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History of Changes from the VAERS Wayback Machine

First Appeared on 9/3/2021

VAERS ID: 1618485
VAERS Form:2
Age:
Sex:Male
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:0000-00-00
Entered:2021-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / OT

Administered by: Unknown      Purchased by: ??
Symptoms: Blood pressure increased, Heart rate increased, Myocarditis

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)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': USMODERNATX, INC.MOD20211

Write-up: Myocarditis; Heart rate increased; Blood pressure increased; This spontaneous case was reported by a consumer and describes the occurrence of MYOCARDITIS (Myocarditis), HEART RATE INCREASED (Heart rate increased) and BLOOD PRESSURE INCREASED (Blood pressure increased) in a male patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced MYOCARDITIS (Myocarditis), HEART RATE INCREASED (Heart rate increased) and BLOOD PRESSURE INCREASED (Blood pressure increased). At the time of the report, MYOCARDITIS (Myocarditis), HEART RATE INCREASED (Heart rate increased) and BLOOD PRESSURE INCREASED (Blood pressure increased) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant medications and treatment medications provided by the reporter. The patient asked if he was reporting a side effect to the vaccine; to which he stated not sure of myocarditis. Also, experienced increased blood pressure and increased heart rate although not significant enough to require hospital. Very limited information regarding these events has been provided at this time. Further information has been requested.; Sender''s Comments: Very limited information regarding these events has been provided at this time. Further information has been requested.

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