Adverse Event Reporting

VAERS ID 907016
Gender Female
Age 40
StateCode IA
Pharmaceutical Company MODERNA
Lot Number 025J2020
Number of vaccinations 1
Vaccinated 2020-12-22
Onset 2020-12-22
  • Dizziness
  • Palpitations
  • Body temperature increased

Current Illness

Preexisting Conditions

Other Medications

Previous Vaccinations



Laboratory Data


Patient complained of "racing heart beat, dizziness" BP noted 141/92 P104 oxygen 99 repeat temp 97.
6 BP 145/89 P96 repeat BP 145/95 Pulse 104 taken to ER for further evaluation and treatment.
Temperature rose to 101 while in ER.
Patient reports symptoms resolved approximately 1 1/2 hours after injection "feels fine" now Discharged home steady gait.