National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

From the 10/8/2021 release of VAERS data:

This is VAERS ID 934279



Case Details

VAERS ID: 934279 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-01-07
Onset:2021-01-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-01-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011L20A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood pressure abnormal, Body temperature increased, Electrocardiogram, Erythema, Full blood count, Headache, Heart rate abnormal, Lymphadenopathy, Metabolic function test, Pain, Palpitations, Petechiae, Rash
SMQs:, Anaphylactic reaction (broad), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Janumet ,Amaryl,Prandin,Losartan,Clonidine,Crestor VitaminC,Vitamin D,Zinc,Magnesium
Current Illness:
Preexisting Conditions: Diabertes,Hypertension,High Cholesterol
Allergies: Penicillin,Sulfa,alcoholic drinks
Diagnostic Lab Data: EKG,CBC,BMP Jan.7,2021
CDC Split Type:

Write-up: Received Moderna covied vaccine @ 8:05 am then 20 minutes after the injection i developed Palpitations HR=130,redness on neck, chest & forehead area, Petechiae rashes on both arms.BP 200/109.was sent to ER for further evaluation.EKG was done,NS 500c given IV ,blood drawn & sent to laboratory for CBC & BMP. released from ER @ 12.30 when my BP & HR was normal.redness on my neck & chest was less but Petechiae rashes subsided in the evening of same day.Early morning Friday Jan.8,2021 temp was 100.2.felt bodyaches & headache. when i checked my temp i noticed a lymph node in my left armpit.


New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=934279

Government Disclaimer on use of this data


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