Adverse Event Reporting
| VAERS ID | 1001590 |
|---|---|
| Gender | Female |
| Age | 93 |
| StateCode | MN |
| Pharmaceutical Company | MODERNA |
| Lot Number | 010M20A |
| Number of vaccinations | 2 |
| Vaccinated | 2021-02-02 |
| Onset | 2021-02-02 |
| Condition | Hospitalized Life Threatening Permanent Disability |
Symptoms
- Feeling abnormal
- Asthenia
- Hypertension
- Unresponsive to stimuli
- Computerised tomogram normal
- Neurological symptom
- Hemiparesis
- Tonic convulsion
- Muscle contracture
Current Illness
Low hemoglobin, syncope, received blood transfusion in hospital on 1/4/21. Received 1st dose of covid vaccine on 1/5/21 morning at the hospital. 1/6/21 had involuntary shaking, not seizure like activity roughly 1800. Talking through shaking, did not lose consciousness. MD was aware. No other illnesses. After second injection on 2/2/21 the resident was eating lunch, nurse was notified that something was off. Resident had what was thought to be a stroke, due to high BP left sided weakness, dazed look, then abrupt contracture of the whole body resident then went limp at 1245 and was unresponsive , sent to ED by EMS. Resident CT was negative, however ED stated stroke was not ruled out. Did have 2 tonic seizures in the ED. Resident returned to facility on 2/3/21 on comfort cares/ actively dying.
Preexisting Conditions
HYPO-OSMOLALITY AND HYPONATREMIA; CONSTIPATION, UNSPECIFIED; IRON DEFICIENCY ANEMIA, UNSPECIFIED; HYPOKALEMIA;VITAMIN D DEFICIENCY, UNSPECIFIED; PVD, OTHER FORMS ACUTE ISCHEMIC HEART DISEASE; DEMENTIA; HTN; MUSCLE WEAKNESS; OSTEOARTHRITIS; CATARACT; MYONEURAL DISORDER, UNSPECIFIED.
Other Medications
Aspirin 81mg daily Aricept 5mg daily Iron 325mg daily lisinopril 40 mg daily potassium 10MEQ daily Senna-docusate sodium 8.6-50 daily vit d 2000 unit
Previous Vaccinations
Allergies
Meclizine
Laboratory Data
See 1st page
Write-up
See 1st page