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This is VAERS ID 907468

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History of Changes from the VAERS Wayback Machine

First Appeared on 12/30/2020

VAERS ID: 907468
VAERS Form:2
Age:52.0
Sex:Female
Location:Kansas
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 025J20-2A / 1 - / IM

Administered by: Other      Purchased by: ??
Symptoms: Confusional state, Fatigue, Feeling cold

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? Yes
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: n/a
CDC 'Split Type':

Write-up: Patient felt chilled and very tired. She started falling asleep while sitting upright. She also became acutely confused and could not identify what year it is, what her phone code was, etc. 911 was notified, but pt felt better about an hour later and did not go to the emergency department for evaluation.


Changed on 5/7/2021

VAERS ID: 907468 Before After
VAERS Form:2
Age:52.0
Sex:Female
Location:Kansas
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 025J20-2A / 1 - / IM

Administered by: Other      Purchased by: ??
Symptoms: Confusional state, Fatigue, Feeling cold

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? Yes
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none none
Diagnostic Lab Data: n/a
CDC 'Split Type':

Write-up: Patient felt chilled and very tired. She started falling asleep while sitting upright. She also became acutely confused and could not identify what year it is, what her phone code was, etc. 911 was notified, but pt felt better about an hour later and did not go to the emergency department for evaluation.


Changed on 5/14/2021

VAERS ID: 907468 Before After
VAERS Form:2
Age:52.0
Sex:Female
Location:Kansas
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 025J20-2A / 1 - / IM

Administered by: Other      Purchased by: ??
Symptoms: Confusional state, Fatigue, Feeling cold

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? Yes
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none none
Diagnostic Lab Data: n/a
CDC 'Split Type':

Write-up: Patient felt chilled and very tired. She started falling asleep while sitting upright. She also became acutely confused and could not identify what year it is, what her phone code was, etc. 911 was notified, but pt felt better about an hour later and did not go to the emergency department for evaluation.

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