Adverse Event Reporting

VAERS ID 908123
Gender Male
Age 43
StateCode NY
Pharmaceutical Company MODERNA
Lot Number 039K20A
Number of vaccinations 1
Vaccinated 2020-12-23
Onset 2020-12-23
Condition Recovered
  • Hyperhidrosis
  • Nausea
  • Pulse abnormal
  • Retching
  • Heart rate decreased
  • Blood pressure immeasurable
  • Pulse absent

Current Illness

hx multiple vasovagal syncope

Preexisting Conditions

Other Medications

Levothyroxine, Tums

Previous Vaccinations



Laboratory Data


Patient became diaphoretic and nauseated about 10 minutes post vaccination with Moderna Covid-19 vaccine.
Patient was assisted to stretcher who he had dry heaves and stated he felt nauseated.
HR was low around 38 and we were unable to determine a B/P but patient had a very weak radial pulse which at times was unable to be felt at all (due to low B/P).
Decision made to transport patient to the ED for further evaluation.
Patient eventually discharged from emergency department.