Adverse Event Reporting
| VAERS ID | 989695 |
|---|---|
| Gender | Male |
| Age | 84 |
| StateCode | CA |
| Pharmaceutical Company | MODERNA |
| Lot Number | 041L20A |
| Number of vaccinations | 1 |
| Vaccinated | 2021-01-23 |
| Onset | 2021-01-24 |
| Condition | Permanent Disability |
Symptoms
- Pain in extremity
- Condition aggravated
- Back pain
- Vaccination complication
- Cardiovascular evaluation
Current Illness
Preexisting Conditions
Back pain due to a fall last February 2000, kyphoplasty surgery last October 2020, and Prostate TURP also in Oc. 2020
Other Medications
Vitamin C, D, Calcium, Fish oil, , multivitamin , stool softener(OTC) Alendronate 70 mg (1x/week); atorvastatin 40 mg, carvedilol 3.1 mg, Eliquis 5mg, levothyroxine 75mcg, memantine 5mg,
Previous Vaccinations
Allergies
None
Laboratory Data
Write-up
Few hours after receiving treatment his arm became very sore which is normal, but the next day he had a severe reaction in his back resulting in an unbearable pain.
Each day the pain has gotten worse and now a week later he is in the worst shape so far.
The primary care Physician has associated the symptoms with the vaccine and on the 25th he saw a cardiologist who again blamed it on the vaccine