Adverse Event Reporting

VAERS ID 931558
Gender Female
Age 47
StateCode AR
Pharmaceutical Company MODERNA
Lot Number 011J20A
Number of vaccinations 1
Vaccinated 2020-12-22
Onset 2020-12-30
Condition Hospitalized Life Threatening Permanent Disability
Symptoms
  • Injection site swelling
  • Injection site pruritus
  • Injection site warmth
  • Laboratory test
  • Computerised tomogram
  • Magnetic resonance imaging brain
  • Scan with contrast
  • Cerebrovascular accident
  • Magnetic resonance imaging neck
  • Hypercoagulation

Current Illness

None

Preexisting Conditions

None

Other Medications

None

Previous Vaccinations

Allergies

None

Laboratory Data

CT with contrast, MRI and MRA of head, MRI neck, expensive labwork

Write-up

7 day after site itching, hot swelling.
Unsure if related 9 day after suffered CVA and have hyper coagulation