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 907546

Government Disclaimer on use of this data



Case Details

VAERS ID: 907546 (history)  
Form: Version 1.0  
Age: 36.0  
Sex: Female  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2020-12-22
Submitted: 2020-12-22
   Days after onset:0
Entered: 2020-12-23
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Other       Purchased by: Other
Symptoms: Dyspnoea, Headache, Hypoaesthesia, Hypoaesthesia oral, Nasal congestion, Nausea, Pallor, Paraesthesia, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (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? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: patient had left arm numbness and tingling, lips numbs, and headache at 15 minutes. Symptoms continued to increased headache, SOB, nasal congestion, nausea and vomiting, all extremities numb. face pale.


New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=907546


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