Adverse Event Reporting

VAERS ID 907085
Gender Female
Age 55
StateCode ND
Pharmaceutical Company MODERNA
Lot Number 025J202A
Number of vaccinations 1
Vaccinated 2020-12-22
Onset 2020-12-22
Condition Recovered
  • Chills
  • Palpitations
  • Immediate post-injection reaction
  • Hot flush

Current Illness

Preexisting Conditions

Other Medications

Previous Vaccinations


Laboratory Data



Patient felt heart racing immediately after getting vaccine.
Vital signs taken: BP163/84 P:150 O2Sa:100% Patient felt hot flush all over face.
Got patient ice water and had patient call for a ride home.
Friend is coming to get her.
Vitals taken 1802: BP: 147/116 P122 SaO2: 100% Patient sitting resting.
Vitals taken: 1809: BP 156/90 P:113 Sao2:100% Patient started having chills - warm blankets given.
Vitals taken 1820: BP: 138/94 P: 109 SaO2:100% T:98*F Patient resting in chair.
Friend arrived to provide ride home.
Vitals taken 1830: 142/84 P:94 SaO2: 100% Vitals taken 1850: BP:127/87 P:102 SaO2: 99% Patient did state that she has been under extreme stress with the death of her husband in November.
And today was her first day back to work.
Had patient stand and walk around a little, no dizziness noted.
Gave her some pretzels to snack on and after 5 minutes she stated she was feeling almost back to normal.
Patient's friend is an RN and was going to have patient spend the night at her home.
Patient stated she did not feel she needed to see a provider and felt that she would be ok in her friends care.