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This is VAERS ID 930187

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History of Changes from the VAERS Wayback Machine

First Appeared on 3/19/2021

VAERS ID: 930187
VAERS Form:2
Age:18.0
Sex:Female
Location:Washington
Vaccinated:2021-01-08
Onset:2021-01-08
Submitted:0000-00-00
Entered:2021-01-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025L20A / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Seizure

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: None known
Current Illness: None
Preexisting Conditions: None. Had brain tumor resection end of 2019
Allergies: None
Diagnostic Lab Data: None here
CDC 'Split Type':

Write-up: Patient had seizure 10 minutes after injection. No history of seizures, but brain tumor resection about a year ago. 911 was called; EMS evaluated and had patient transported to hospital


Changed on 5/7/2021

VAERS ID: 930187 Before After
VAERS Form:2
Age:18.0
Sex:Female
Location:Washington
Vaccinated:2021-01-08
Onset:2021-01-08
Submitted:0000-00-00
Entered:2021-01-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025L20A / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Seizure

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: None known
Current Illness: None
Preexisting Conditions: None. Had brain tumor resection end of 2019
Allergies: None None
Diagnostic Lab Data: None here
CDC 'Split Type':

Write-up: Patient had seizure 10 minutes after injection. No history of seizures, but brain tumor resection about a year ago. 911 was called; EMS evaluated and had patient transported to hospital


Changed on 5/21/2021

VAERS ID: 930187 Before After
VAERS Form:2
Age:18.0
Sex:Female
Location:Washington
Vaccinated:2021-01-08
Onset:2021-01-08
Submitted:0000-00-00
Entered:2021-01-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025L20A / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Seizure

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: None known
Current Illness: None
Preexisting Conditions: None. Had brain tumor resection end of 2019
Allergies: None None
Diagnostic Lab Data: None here
CDC 'Split Type':

Write-up: Patient had seizure 10 minutes after injection. No history of seizures, but brain tumor resection about a year ago. 911 was called; EMS evaluated and had patient transported to hospital

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=930187&WAYBACKHISTORY=ON


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