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This is VAERS ID 907459

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History of Changes from the VAERS Wayback Machine

First Appeared on 12/30/2020

VAERS ID: 907459
VAERS Form:2
Age:50.0
Sex:Male
Location:Colorado
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: Military      Purchased by: ??
Symptoms: Condition aggravated, Fatigue, Nausea, Pain in extremity, Sleep disorder, Tinnitus

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? No
Previous Vaccinations:
Other Medications: generic zyrtec
Current Illness: none
Preexisting Conditions: tinnitus
Allergies: lactose intolerant
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Moderna COVID-19 Vaccine EUA Left arm pain started 15 min post vaccination and has not subsided. General fatigue started 2 hours post vaccination and has not subsided. Nausea started 5 hours post vaccination and subsided by 4:45AM the following day. Tinnitus usually sits at 2 on a scale of 1 to 10 with 10 being obnoxiously loud and distracting causing lack of concentration. Tinnitus started to increase 2 hours post vaccination and topped out at about 8 at around 6 hours post vaccination. Could not sleep well and maybe got 2 hours of sleep due to tinnitus and increasing left arm pain.


Changed on 5/7/2021

VAERS ID: 907459 Before After
VAERS Form:2
Age:50.0
Sex:Male
Location:Colorado
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: Military      Purchased by: ??
Symptoms: Condition aggravated, Fatigue, Nausea, Pain in extremity, Sleep disorder, Tinnitus

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? No
Previous Vaccinations:
Other Medications: generic zyrtec
Current Illness: none
Preexisting Conditions: tinnitus
Allergies: lactose intolerant intolerant
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Moderna COVID-19 Vaccine EUA Left arm pain started 15 min post vaccination and has not subsided. General fatigue started 2 hours post vaccination and has not subsided. Nausea started 5 hours post vaccination and subsided by 4:45AM the following day. Tinnitus usually sits at 2 on a scale of 1 to 10 with 10 being obnoxiously loud and distracting causing lack of concentration. Tinnitus started to increase 2 hours post vaccination and topped out at about 8 at around 6 hours post vaccination. Could not sleep well and maybe got 2 hours of sleep due to tinnitus and increasing left arm pain.


Changed on 5/21/2021

VAERS ID: 907459 Before After
VAERS Form:2
Age:50.0
Sex:Male
Location:Colorado
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: Military      Purchased by: ??
Symptoms: Condition aggravated, Fatigue, Nausea, Pain in extremity, Sleep disorder, Tinnitus

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? No
Previous Vaccinations:
Other Medications: generic zyrtec
Current Illness: none
Preexisting Conditions: tinnitus
Allergies: lactose intolerant intolerant
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Moderna COVID-19 Vaccine EUA Left arm pain started 15 min post vaccination and has not subsided. General fatigue started 2 hours post vaccination and has not subsided. Nausea started 5 hours post vaccination and subsided by 4:45AM the following day. Tinnitus usually sits at 2 on a scale of 1 to 10 with 10 being obnoxiously loud and distracting causing lack of concentration. Tinnitus started to increase 2 hours post vaccination and topped out at about 8 at around 6 hours post vaccination. Could not sleep well and maybe got 2 hours of sleep due to tinnitus and increasing left arm pain.

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