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This is VAERS ID 911898

History of Changes from the VAERS Wayback Machine

First Appeared on 1/22/2021

VAERS ID: 911898
VAERS Form:2
Age:37.0
Sex:Male
Location:New Jersey
Vaccinated:2020-12-27
Onset:2020-12-28
Submitted:0000-00-00
Entered:2020-12-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Facial paralysis, Injection site pain, Sensory loss, Muscle tightness, Facial nerve disorder, Computerised tomogram head normal

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: asthma, diabetes type 2, HTN, psoriasis
Allergies: cat dander
Diagnostic Lab Data: Head CT; negative
CDC 'Split Type':

Write-up: After injection, within 1 hour, started having left arm muscle tightening, up to left shoulder. Following morning: facial numbnes/decreased sensation; mild facial droop. Onset 9am on 12/28/2020. Went to ED for evaluation. Sensation started to resolve, continues to be slightly diminished on left side of face. Droop has since resolved.


Changed on 5/7/2021

VAERS ID: 911898 Before After
VAERS Form:2
Age:37.0
Sex:Male
Location:New Jersey
Vaccinated:2020-12-27
Onset:2020-12-28
Submitted:0000-00-00
Entered:2020-12-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Facial paralysis, Injection site pain, Sensory loss, Muscle tightness, Facial nerve disorder, Computerised tomogram head normal

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: asthma, diabetes type 2, HTN, psoriasis
Allergies: cat dander dander
Diagnostic Lab Data: Head CT; negative
CDC 'Split Type':

Write-up: After injection, within 1 hour, started having left arm muscle tightening, up to left shoulder. Following morning: facial numbnes/decreased sensation; mild facial droop. Onset 9am on 12/28/2020. Went to ED for evaluation. Sensation started to resolve, continues to be slightly diminished on left side of face. Droop has since resolved.


Changed on 5/14/2021

VAERS ID: 911898 Before After
VAERS Form:2
Age:37.0
Sex:Male
Location:New Jersey
Vaccinated:2020-12-27
Onset:2020-12-28
Submitted:0000-00-00
Entered:2020-12-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Facial paralysis, Injection site pain, Sensory loss, Muscle tightness, Facial nerve disorder, Computerised tomogram head normal

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: asthma, diabetes type 2, HTN, psoriasis
Allergies: cat dander dander
Diagnostic Lab Data: Head CT; negative
CDC 'Split Type':

Write-up: After injection, within 1 hour, started having left arm muscle tightening, up to left shoulder. Following morning: facial numbnes/decreased sensation; mild facial droop. Onset 9am on 12/28/2020. Went to ED for evaluation. Sensation started to resolve, continues to be slightly diminished on left side of face. Droop has since resolved.

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https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=911898&WAYBACKHISTORY=ON


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