National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

From the 11/19/2021 release of VAERS data:

This is VAERS ID 907085

Government Disclaimer on use of this data

Case Details

VAERS ID: 907085 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: North Dakota  
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2020-12-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025J20-2A / 1 RA / -

Administered by: Private       Purchased by: ?
Symptoms: Chills, Hot flush, Immediate post-injection reaction, Palpitations
SMQs:, Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Hypersensitivity (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Patient felt heart racing immediately after getting vaccine. Vital signs taken: BP163/84 P:150 O2Sa:100% Patient felt hot flush all over face. Got patient ice water and had patient call for a ride home. Friend is coming to get her. Vitals taken 1802: BP: 147/116 P122 SaO2: 100% Patient sitting resting. Vitals taken: 1809: BP 156/90 P:113 Sao2:100% Patient started having chills - warm blankets given. Vitals taken 1820: BP: 138/94 P: 109 SaO2:100% T:98*F Patient resting in chair. Friend arrived to provide ride home. Vitals taken 1830: 142/84 P:94 SaO2: 100% Vitals taken 1850: BP:127/87 P:102 SaO2: 99% Patient did state that she has been under extreme stress with the death of her husband in November. And today was her first day back to work. Had patient stand and walk around a little, no dizziness noted. Gave her some pretzels to snack on and after 5 minutes she stated she was feeling almost back to normal. Patient''s friend is an RN and was going to have patient spend the night at her home. Patient stated she did not feel she needed to see a provider and felt that she would be ok in her friends care.

New Search

Link To This Search Result:

Copyright © 2021 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166