Adverse Event Reporting
| VAERS ID | 1005704 |
|---|---|
| Gender | Female |
| Age | 82 |
| StateCode | NC |
| Pharmaceutical Company | MODERNA |
| Lot Number | 013L20A |
| Number of vaccinations | 1 |
| Vaccinated | 2021-01-25 |
| Onset | 2021-01-26 |
| Condition | Hospitalized Permanent Disability |
Symptoms
- Confusional state
- Transient ischaemic attack
- Amnesia
Current Illness
UNKNOWN
Preexisting Conditions
UNKNOWN
Other Medications
UNKNOWN
Previous Vaccinations
Allergies
UNKNOWN
Laboratory Data
unknown
Write-up
Pt's son called and reported that pt had COVID vaccine on 1-25-21 and was taken to the hospital via EMS due to confusion and memory loss.
Pt's son states that pt was diagnosed with "TIA" and stayed in the hospital x 3 days.
Pt states that the physicians at facility was not sure if TIA was related to vaccine but encouraged him to report adverse event.
Pt's son states that pt has short term memory loss and has since moved in with him after this event happened.