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This is VAERS ID 919675

History of Changes from the VAERS Wayback Machine

First Appeared on 2/18/2021

VAERS ID: 919675
VAERS Form:2
Age:26.0
Sex:Female
Location:Texas
Vaccinated:2020-12-30
Onset:2021-01-04
Submitted:0000-00-00
Entered:2021-01-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037K28 / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Facial paralysis, Hypoaesthesia, Lacrimation increased, Eyelid function disorder

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? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: Avocado, bananas, latex
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Bell?s Palsy. Right-sided facial drooping. Numbness to right face. Excessive tearing of right eye associated with inability to blink right eye.


Changed on 5/7/2021

VAERS ID: 919675 Before After
VAERS Form:2
Age:26.0
Sex:Female
Location:Texas
Vaccinated:2020-12-30
Onset:2021-01-04
Submitted:0000-00-00
Entered:2021-01-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037K28 / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Facial paralysis, Hypoaesthesia, Lacrimation increased, Eyelid function disorder

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? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: Avocado, bananas, latex latex
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Bell?s Palsy. Right-sided facial drooping. Numbness to right face. Excessive tearing of right eye associated with inability to blink right eye.


Changed on 5/14/2021

VAERS ID: 919675 Before After
VAERS Form:2
Age:26.0
Sex:Female
Location:Texas
Vaccinated:2020-12-30
Onset:2021-01-04
Submitted:0000-00-00
Entered:2021-01-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037K28 / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Facial paralysis, Hypoaesthesia, Lacrimation increased, Eyelid function disorder

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? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: Avocado, bananas, latex latex
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Bell?s Palsy. Right-sided facial drooping. Numbness to right face. Excessive tearing of right eye associated with inability to blink right eye.

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https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=919675&WAYBACKHISTORY=ON


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