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This is VAERS ID 907423

History of Changes from the VAERS Wayback Machine

First Appeared on 12/30/2020

VAERS ID: 907423
VAERS Form:2
Age:26.0
Sex:Female
Location:Arizona
Vaccinated:2020-12-22
Onset:2020-12-22
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, Dyspnoea, Electrocardiogram, Hypoaesthesia, Nausea, Pregnancy test, Speech disorder, Swollen tongue, Computerised tomogram head, Laboratory test

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? 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.


Changed on 5/7/2021

VAERS ID: 907423 Before After
VAERS Form:2
Age:26.0
Sex:Female
Location:Arizona
Vaccinated:2020-12-22
Onset:2020-12-22
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, Dyspnoea, Electrocardiogram, Hypoaesthesia, Nausea, Pregnancy test, Speech disorder, Swollen tongue, Computerised tomogram head, Laboratory test

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? 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 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.


Changed on 5/14/2021

VAERS ID: 907423 Before After
VAERS Form:2
Age:26.0
Sex:Female
Location:Arizona
Vaccinated:2020-12-22
Onset:2020-12-22
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, Dyspnoea, Electrocardiogram, Hypoaesthesia, Nausea, Pregnancy test, Speech disorder, Swollen tongue, Computerised tomogram head, Laboratory test

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? 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 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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