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 907248

Government Disclaimer on use of this data



Case Details

VAERS ID: 907248 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Male  
Location: Tennessee  
Vaccinated:2020-12-22
Onset:2020-12-23
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2020-12-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011J20A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Body temperature increased, Pain in extremity
SMQs:, Neuroleptic malignant syndrome (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: No no illnesses the previous month.
Preexisting Conditions: Unknown
Allergies: Reported a reaction to sulfa. Not hospitalized due to previous sulfa reaction.
Diagnostic Lab Data: Patient instructed to follow up with PCP concerning any follow up or testing.
CDC Split Type:

Write-up: Notified by girlfriend. Patient woke up this morning with arm soreness. States temperature 102.3 this am. Instructed to call primary care. Instructed patient could have COVID or flu not related to shot. Waited 30 minutes post vaccination, without complication.


New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=907248


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