National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 907878

Government Disclaimer on use of this data

History of Changes from the VAERS Wayback Machine

First Appeared on 12/30/2020

VAERS ID: 907878
VAERS Form:2
Age:52.0
Sex:Female
Location:Missouri
Vaccinated:2020-12-23
Onset:2020-12-23
Submitted:0000-00-00
Entered:2020-12-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025J20-2A / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Chest discomfort, Dizziness, Dysphagia, Dyspnoea, Headache, Oxygen saturation normal, Emotional distress, Limb discomfort

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)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient received COVID vaccine at approximately 9AM this morning. Stayed 15 minutes after injection for monitoring, felt fine and returned to department. Employee returned at approximately 11:45AM with possible symptoms of reaction. Admitted to a headache that started approximately an hour after injection. Symptoms now include heaviness of arm, chest, feeling emotional, light headed. Vitals taken at 11:48 BP 150/86, P 79, R16 Pox 97. Oral Benadryl 25mg administered PO 11:50AM. EKG run. Patients symptoms progressed to include difficulty breathing and swallowing. Epi pen adult 0.3mg administered IM Left thigh at 12:13PM. Vitals checked at 12:13PM BP 188/90, pulse 97, pulse ox97. Called for emergency response for transport to ER. Pt remained stable until transport by EMS to ER. Employee health informed of patient transport. ER informed of patient transport.


Changed on 5/7/2021

VAERS ID: 907878 Before After
VAERS Form:2
Age:52.0
Sex:Female
Location:Missouri
Vaccinated:2020-12-23
Onset:2020-12-23
Submitted:0000-00-00
Entered:2020-12-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025J20-2A / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Chest discomfort, Dizziness, Dysphagia, Dyspnoea, Headache, Oxygen saturation normal, Emotional distress, Limb discomfort

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)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient received COVID vaccine at approximately 9AM this morning. Stayed 15 minutes after injection for monitoring, felt fine and returned to department. Employee returned at approximately 11:45AM with possible symptoms of reaction. Admitted to a headache that started approximately an hour after injection. Symptoms now include heaviness of arm, chest, feeling emotional, light headed. Vitals taken at 11:48 BP 150/86, P 79, R16 Pox 97. Oral Benadryl 25mg administered PO 11:50AM. EKG run. Patients symptoms progressed to include difficulty breathing and swallowing. Epi pen adult 0.3mg administered IM Left thigh at 12:13PM. Vitals checked at 12:13PM BP 188/90, pulse 97, pulse ox97. Called for emergency response for transport to ER. Pt remained stable until transport by EMS to ER. Employee health informed of patient transport. ER informed of patient transport.


Changed on 5/14/2021

VAERS ID: 907878 Before After
VAERS Form:2
Age:52.0
Sex:Female
Location:Missouri
Vaccinated:2020-12-23
Onset:2020-12-23
Submitted:0000-00-00
Entered:2020-12-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025J20-2A / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Chest discomfort, Dizziness, Dysphagia, Dyspnoea, Headache, Oxygen saturation normal, Emotional distress, Limb discomfort

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)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient received COVID vaccine at approximately 9AM this morning. Stayed 15 minutes after injection for monitoring, felt fine and returned to department. Employee returned at approximately 11:45AM with possible symptoms of reaction. Admitted to a headache that started approximately an hour after injection. Symptoms now include heaviness of arm, chest, feeling emotional, light headed. Vitals taken at 11:48 BP 150/86, P 79, R16 Pox 97. Oral Benadryl 25mg administered PO 11:50AM. EKG run. Patients symptoms progressed to include difficulty breathing and swallowing. Epi pen adult 0.3mg administered IM Left thigh at 12:13PM. Vitals checked at 12:13PM BP 188/90, pulse 97, pulse ox97. Called for emergency response for transport to ER. Pt remained stable until transport by EMS to ER. Employee health informed of patient transport. ER informed of patient transport.

New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=907878&WAYBACKHISTORY=ON


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