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This is VAERS ID 908184

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History of Changes from the VAERS Wayback Machine

First Appeared on 12/30/2020

VAERS ID: 908184
VAERS Form:2
Age:48.0
Sex:Female
Location:Unknown
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 011J20A / 1 LA / IM

Administered by: Unknown      Purchased by: ??
Symptoms: Anxiety, Headache, Hypertension

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt. c/o moderate anxiety during vaccine. Around 15 mons after the vaccine , she c/o mild headache and stated she has history of HTN. She was hypertensive and her pulse was WNL. She was rechecked in 15 mins and her BP decreased and HR stable with continued headache. The patient denied any other symptoms and declined going to the ED. She left without further complaints 45 mins after her vaccine.


Changed on 5/7/2021

VAERS ID: 908184 Before After
VAERS Form:2
Age:48.0
Sex:Female
Location:Unknown
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 011J20A / 1 LA / IM

Administered by: Unknown      Purchased by: ??
Symptoms: Anxiety, Headache, Hypertension

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt. c/o moderate anxiety during vaccine. Around 15 mons after the vaccine , she c/o mild headache and stated she has history of HTN. She was hypertensive and her pulse was WNL. She was rechecked in 15 mins and her BP decreased and HR stable with continued headache. The patient denied any other symptoms and declined going to the ED. She left without further complaints 45 mins after her vaccine.


Changed on 5/21/2021

VAERS ID: 908184 Before After
VAERS Form:2
Age:48.0
Sex:Female
Location:Unknown
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 011J20A / 1 LA / IM

Administered by: Unknown      Purchased by: ??
Symptoms: Anxiety, Headache, Hypertension

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt. c/o moderate anxiety during vaccine. Around 15 mons after the vaccine , she c/o mild headache and stated she has history of HTN. She was hypertensive and her pulse was WNL. She was rechecked in 15 mins and her BP decreased and HR stable with continued headache. The patient denied any other symptoms and declined going to the ED. She left without further complaints 45 mins after her vaccine.

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