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This is VAERS ID 1735301

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History of Changes from the VAERS Wayback Machine

First Appeared on 10/1/2021

VAERS ID: 1735301
VAERS Form:2
Age:77.0
Sex:Male
Location:Texas
Vaccinated:2021-09-12
Onset:2021-09-13
Submitted:0000-00-00
Entered:2021-09-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 051E21A / 1 LA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Pain in extremity, Sinus headache, Throat tightness, Ear discomfort, Pharyngeal swelling

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':

Write-up: Pt reported adverse effects after 1st Moderna vaccine (administered on 9/12/21). Pt said he does not have a headache. However, he developed a sore arm for 1 week which has resolved. In addition, pt felt like his throat was closing up/felt swollen 1 day after vaccine (symptoms have improved per pt), and right ear feels plugged up. Pt said he has been using Nascort and OTC antihistamine that helps with sinus headache (pt does not know the name of the product). I recommended pt to continued using those products, since pt thinks it has been helping improve his symptoms. I left a message with pt''s PCP to inform of pt''s adverse reaction after 1st Moderna vaccine. Pt said he thinks his symptoms are improving, but wasn''t sure if should get the 2nd Moderna dose. 2nd dose should be okay, since pt did not have anaphylaxis. However, informed pt to follow-up with PCP if symptoms do not improve and see what the provider recommends for the pt. In addition, recommended pt to go the ER if pt''s throat closed up or if he felt like he couldn''t breath.

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