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This is VAERS ID 906991

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History of Changes from the VAERS Wayback Machine

First Appeared on 12/30/2020

VAERS ID: 906991
VAERS Form:2
Age:43.0
Sex:Female
Location:New Mexico
Vaccinated:2020-12-22
Onset:2020-12-22
Submitted:0000-00-00
Entered:2020-12-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011J20A / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Blood glucose normal, Dizziness, Vertigo

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: Sumatriptan 50 mg PRN, Albuterol neb and inhaler PRN, Vitamin D 2000 units, Metformin 500 mg, Gabapentin 300 mg, Levothyroxine 88 mcg, Ibuprofen 800 mg, Propranolol 10 mg, Atorvastatin 10 mg,
Current Illness: n/a
Preexisting Conditions: Type 2 diabetes, hypothyroidism, moderate asthma, obstructive sleep apnea, insomnia, polyarthralgia, GERD, chronic migraine, obesity, hyperlipidemia, fatigue, tobacco use disorder, elevated blood pressure, vitamin d deficiency, environmental allergies
Allergies: Sulfa drugs, peanuts
Diagnostic Lab Data: Patients blood glucose was 144, BP 151/84, HR 78 bpm, and O2 was at 98% RA
CDC 'Split Type':

Write-up: Patient reported becoming dizzy 12 minutes after receiving injection. Patient felt like she was going to faint. Patient was placed on floor with legs elevated and given a snack and a sugary drink. Felt better left facility and called in reporting when she got down to go inside her home she had a repeat episode of vertigo.


Changed on 5/7/2021

VAERS ID: 906991 Before After
VAERS Form:2
Age:43.0
Sex:Female
Location:New Mexico
Vaccinated:2020-12-22
Onset:2020-12-22
Submitted:0000-00-00
Entered:2020-12-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011J20A / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Blood glucose normal, Dizziness, Vertigo

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: Sumatriptan 50 mg PRN, Albuterol neb and inhaler PRN, Vitamin D 2000 units, Metformin 500 mg, Gabapentin 300 mg, Levothyroxine 88 mcg, Ibuprofen 800 mg, Propranolol 10 mg, Atorvastatin 10 mg,
Current Illness: n/a
Preexisting Conditions: Type 2 diabetes, hypothyroidism, moderate asthma, obstructive sleep apnea, insomnia, polyarthralgia, GERD, chronic migraine, obesity, hyperlipidemia, fatigue, tobacco use disorder, elevated blood pressure, vitamin d deficiency, environmental allergies
Allergies: Sulfa drugs, peanuts peanuts
Diagnostic Lab Data: Patients blood glucose was 144, BP 151/84, HR 78 bpm, and O2 was at 98% RA
CDC 'Split Type':

Write-up: Patient reported becoming dizzy 12 minutes after receiving injection. Patient felt like she was going to faint. Patient was placed on floor with legs elevated and given a snack and a sugary drink. Felt better left facility and called in reporting when she got down to go inside her home she had a repeat episode of vertigo.


Changed on 5/14/2021

VAERS ID: 906991 Before After
VAERS Form:2
Age:43.0
Sex:Female
Location:New Mexico
Vaccinated:2020-12-22
Onset:2020-12-22
Submitted:0000-00-00
Entered:2020-12-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011J20A / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Blood glucose normal, Dizziness, Vertigo

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: Sumatriptan 50 mg PRN, Albuterol neb and inhaler PRN, Vitamin D 2000 units, Metformin 500 mg, Gabapentin 300 mg, Levothyroxine 88 mcg, Ibuprofen 800 mg, Propranolol 10 mg, Atorvastatin 10 mg,
Current Illness: n/a
Preexisting Conditions: Type 2 diabetes, hypothyroidism, moderate asthma, obstructive sleep apnea, insomnia, polyarthralgia, GERD, chronic migraine, obesity, hyperlipidemia, fatigue, tobacco use disorder, elevated blood pressure, vitamin d deficiency, environmental allergies
Allergies: Sulfa drugs, peanuts peanuts
Diagnostic Lab Data: Patients blood glucose was 144, BP 151/84, HR 78 bpm, and O2 was at 98% RA
CDC 'Split Type':

Write-up: Patient reported becoming dizzy 12 minutes after receiving injection. Patient felt like she was going to faint. Patient was placed on floor with legs elevated and given a snack and a sugary drink. Felt better left facility and called in reporting when she got down to go inside her home she had a repeat episode of vertigo.

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