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This is VAERS ID 919154

History of Changes from the VAERS Wayback Machine

First Appeared on 1/7/2021

VAERS ID: 919154
VAERS Form:2
Age:38.0
Sex:Female
Location:Iowa
Vaccinated:2020-12-29
Onset:2020-12-29
Submitted:0000-00-00
Entered:2021-01-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025J20-2A / 1 RA / IM

Administered by: Private      Purchased by: ??
Symptoms: Computerised tomogram normal, Ear pain, Facial paralysis, Hypoaesthesia, Pain in extremity, Paraesthesia, Hypoaesthesia oral

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Probiotic
Current Illness: N/A
Preexisting Conditions: Crohns Disease
Allergies: Azithromycin (patient has an upset stomach when taking), patient also has sensitivity when eating chocolate, pineapple or highly processed foods (due to Crohn''s Disease)
Diagnostic Lab Data: CT scan done on 1-2-21 -negative for hemorrhage
CDC 'Split Type':

Write-up: Patients adverse reactions started day of vaccination with right arm pain up to right ear as well as complete tongue numbness. On 1-1-21 patient had increased Bell''s Palsy symptoms including; inability to raise left eyebrow, inability to close left eye in its entirety, teeth being numb on left side, and numbness and tingling in left foot and left hand (from palm to fingers). ER physician prescribed on 1-1 Prednisone, Keflex and Valtrex. Patient went to ER again on 1-2-21 with lower extremity numbness on left side that is moving proximally toward her hip. Patient went home on 1-3-21 with an RX for Prednisone as well as Valtrex. Symptoms have improved but have not fully resolved at this time.


Changed on 5/7/2021

VAERS ID: 919154 Before After
VAERS Form:2
Age:38.0
Sex:Female
Location:Iowa
Vaccinated:2020-12-29
Onset:2020-12-29
Submitted:0000-00-00
Entered:2021-01-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025J20-2A / 1 RA / IM

Administered by: Private      Purchased by: ??
Symptoms: Computerised tomogram normal, Ear pain, Facial paralysis, Hypoaesthesia, Pain in extremity, Paraesthesia, Hypoaesthesia oral

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Probiotic
Current Illness: N/A
Preexisting Conditions: Crohns Disease
Allergies: Azithromycin (patient has an upset stomach when taking), patient also has sensitivity when eating chocolate, pineapple or highly processed foods (due to Crohn''s Disease) Disease)
Diagnostic Lab Data: CT scan done on 1-2-21 -negative for hemorrhage
CDC 'Split Type':

Write-up: Patients adverse reactions started day of vaccination with right arm pain up to right ear as well as complete tongue numbness. On 1-1-21 patient had increased Bell''s Palsy symptoms including; inability to raise left eyebrow, inability to close left eye in its entirety, teeth being numb on left side, and numbness and tingling in left foot and left hand (from palm to fingers). ER physician prescribed on 1-1 Prednisone, Keflex and Valtrex. Patient went to ER again on 1-2-21 with lower extremity numbness on left side that is moving proximally toward her hip. Patient went home on 1-3-21 with an RX for Prednisone as well as Valtrex. Symptoms have improved but have not fully resolved at this time.


Changed on 5/14/2021

VAERS ID: 919154 Before After
VAERS Form:2
Age:38.0
Sex:Female
Location:Iowa
Vaccinated:2020-12-29
Onset:2020-12-29
Submitted:0000-00-00
Entered:2021-01-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025J20-2A / 1 RA / IM

Administered by: Private      Purchased by: ??
Symptoms: Computerised tomogram normal, Ear pain, Facial paralysis, Hypoaesthesia, Pain in extremity, Paraesthesia, Hypoaesthesia oral

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Probiotic
Current Illness: N/A
Preexisting Conditions: Crohns Disease
Allergies: Azithromycin (patient has an upset stomach when taking), patient also has sensitivity when eating chocolate, pineapple or highly processed foods (due to Crohn''s Disease) Disease)
Diagnostic Lab Data: CT scan done on 1-2-21 -negative for hemorrhage
CDC 'Split Type':

Write-up: Patients adverse reactions started day of vaccination with right arm pain up to right ear as well as complete tongue numbness. On 1-1-21 patient had increased Bell''s Palsy symptoms including; inability to raise left eyebrow, inability to close left eye in its entirety, teeth being numb on left side, and numbness and tingling in left foot and left hand (from palm to fingers). ER physician prescribed on 1-1 Prednisone, Keflex and Valtrex. Patient went to ER again on 1-2-21 with lower extremity numbness on left side that is moving proximally toward her hip. Patient went home on 1-3-21 with an RX for Prednisone as well as Valtrex. Symptoms have improved but have not fully resolved at this time.

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