VAERS ID: 908771

AGE: 62| SEX: F|STATE: OR (United States)

Description

12/22 7 pm, severe leg cramps; 12/23 7 am: diarrhea, abdominal pain. noon: nausea requiring medication; 5 pm, shaking chills, normal temperature. 9 pm: bloody diarrhea, and what looked more like sloughing nonpigmented tissue rather than stool, continued abdominal pain. Woke with diarrhea and pain 1 am. This morning, frequent stool and moderate abdominal pain. No chills. Recovered from diverticulitis around 12/3, scheduled for colonoscopy 1/6/21 and probably colectomy 1/8/2021.

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Symptoms

Chills, Nausea, Abdominal pain, Pain, Diarrhoea haemorrhagic, Tremor, Diarrhoea, Muscle spasms, Faeces discoloured, Frequent bowel movements

Vaccines

VAX DATE: 12-22-2020| ONSET DATE: 12-22-2020| DAYS TO ONSET: 0
NameDose #TypeManufacturerLotRouteSite
COVID19 (COVID19 (MODERNA)) 1 COVID19 MODERNA 011320A IM LA

RECVDATE:12-24-2020
RPT_DATE:
CAGE_YR:62
CAGE_MO:
DIED:U
DATEDIED:
L_THREAT:U
ER_VISIT:
HOSPITAL:U
HOSPDAYS:
X_STAY:U
DISABLE:U
RECOVD:N
LAB_DATA:none
V_ADMINBY:PVT
OTHER_MEDS:Multiple vitamin. Cetrizine 10 mg. Turmeric 750 mg. ASA 81 mg; EPA/DHA; co Q 10 100 mg; potassium citrate 99 mg; magnesium 400 mg ; probiotic; macuguard (life extension), vitamin D 5,000 iu, zinc, valerian, horse chestnut, butcher broom
CUR_ILL:Diverticulitis (recovered approx 12/3)
HISTORY:recurrent uncomplicated diverticulitis; myofascial pain (neck upper back)
PRIOR_VAX:
SPLTTYPE:
FORM_VERS:
TODAYS_DATE:12-24-2020
BIRTH_DEFECT:U
OFC_VISIT:U
ER_ED_VISIT:U
ALLERGIES:shellfish (crab shrimp)
V_FUNDBY:

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