Adverse Event Reporting

VAERS ID 906394
Gender Male
Age 69
StateCode MS
Pharmaceutical Company MODERNA
Lot Number 011J20A
Number of vaccinations
Vaccinated 2020-12-21
Onset 2020-12-21
Condition Recovered
  • Injection site pain
  • Vertigo

Current Illness

Preexisting Conditions

Stable T2DM, Stable HTN, BPH, OA

Other Medications

Metformin, Glipizide, Losartan, Simvastatin, Vit D, Flomax

Previous Vaccinations


Penicillin, Tincture of Benzoin

Laboratory Data



Left UE injection site soreness 4 hours post.
Severe vertigo approximately 10 hours after, lasting about 4 hours.