Adverse Event Reporting

VAERS ID 906931
Gender Female
Age 33
StateCode CO
Pharmaceutical Company MODERNA
Lot Number 011J20A
Number of vaccinations 1
Vaccinated 2020-12-22
Onset 2020-12-22
  • Headache
  • Dizziness
  • Chest discomfort

Current Illness

Preexisting Conditions

Other Medications

Epidural steroid injection approximately 10 days prior

Previous Vaccinations


Shellfish, Iodine, Sulfa

Laboratory Data


Pt experienced headache and dizziness immediately after injection.
Approximately 30 mins later the patient began experiencing chest tightness.
The patient received 50mg Benadryl and was transferred to the emergency department within about 20 mins.