National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts.org
Search Results

From the 4/30/2021 release of VAERS data (an older release, current is 1/14/2022):

This is VAERS ID 1023871

Government Disclaimer on use of this data



Case Details

VAERS ID: 1023871 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Female  
Location: Kansas  
Vaccinated:2021-02-10
Onset:2021-02-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-02-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / IM

Administered by: Private       Purchased by: ?
Symptoms: Abnormal behaviour, Blood test, Computerised tomogram, Electrocardiogram, Ischaemic stroke, X-ray
SMQs:, Ischaemic central nervous system vascular conditions (narrow), Dementia (broad), Embolic and thrombotic events, arterial (narrow), Psychosis and psychotic disorders (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Hostility/aggression (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Diagnosed with COVID 19 in December. Required hospitalization.
Allergies: Sulfa, Bactrim, PCN
Diagnostic Lab Data: ECG, CT, blood studies, Xray,
CDC Split Type:

Write-up: Patient received vaccine during working hours on 2/10/2021. Coworkers reported patient was acting abnormally this morning upon arriving to work. After medical assessment and testing, patient was diagnosed with a ischemic stroke and transferred to higher level of care.


New Search

Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20210430&IDNUMBER=1023871


Copyright © 2022 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166