Adverse Event Reporting

VAERS ID 1139779
Gender Unknown
Age
StateCode FL
Pharmaceutical Company MODERNA
Lot Number 029A21A
Number of vaccinations 1
Vaccinated
Onset
Condition Hospitalized Life Threatening Permanent Disability Recovered
Symptoms
  • Syncope
  • Acute kidney injury
  • Hyperkalaemia
  • Cardiac failure congestive
  • Cardiac pacemaker insertion
  • Accelerated hypertension
  • Hypomagnesaemia

Current Illness

Preexisting Conditions

Other Medications

Previous Vaccinations

Allergies

Laboratory Data

Ended up with implanting a pace maker

Write-up

Acute diastolic congestive heart failure, Accelerated hypertension, Acute injury to kidney, Hypomagnesemia, Hyperkalemia,Syncope and collapse