Adverse Event Reporting

VAERS ID 915473
Gender Unknown
Age 30
StateCode WI
Pharmaceutical Company MODERNA
Lot Number 011J20A
Number of vaccinations 1
Vaccinated 2020-12-31
Onset 2020-12-31
Condition
Symptoms
  • Dizziness
  • Nausea
  • Anxiety

Current Illness

Preexisting Conditions

Other Medications

Previous Vaccinations

Allergies

Laboratory Data

Write-up

Patient got vaccine at 8:17am and started feeling nauseous and lightheaded at 8:32am.
8:33 BP was 100/50 and HR of 80.
At 8:51 BP was 110/80 and HR 80.
At that time, she had some crackers and water.
She reported having issues in the past with fainting when seeing needles.
We elevated patients legs and put ice packs on head.
She started feeling less nauseaous after a while of laying down but was still anxious.
Patient has a history of anxiety and takes medications for it.
Patients husband came in to help patient leave.
Told patient we could bring her to the ER to get evaluated and she declined.
When walking outside the room and walking around more, she started to not feel nauseous anymore and just felt anxious.
Told patient if any other symptoms occur please go to ER.
She stated she understood.