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From the 10/15/2021 release of VAERS data:

This is VAERS ID 907423



Case Details

VAERS ID: 907423 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Arizona  
Vaccinated:2020-12-22
Onset:2020-12-22
   Days after vaccination:0
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: Private       Purchased by: ?
Symptoms: Asthenia, Chest X-ray, Computerised tomogram head, Dyspnoea, Electrocardiogram, Hypoaesthesia, Laboratory test, Nausea, Pregnancy test, Speech disorder, Swollen tongue
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (narrow), Peripheral neuropathy (broad), Dementia (broad), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Psychosis and psychotic disorders (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: Laparoscopic Cholecystectomy on 11-6-2020
Preexisting Conditions: None
Allergies: Keflex and Tramadol
Diagnostic Lab Data: CT of head, routine labs, chest x-ray, pregnancy test, neurology consulting, EKG
CDC Split Type:

Write-up: Onset of symptoms began approximately 1.5 hours after vaccination. Patient became weak c/o tongue swelling, nausea, difficulty breathing, numbness especially in lower extremities. Felt she couldn''t breath, numbness continued to get worse and affected her upper extremities as well, weak speech.


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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=907423

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