VAERS ID: 915082

AGE: 52| SEX: F|STATE: TX (United States)

Description

1627: informed patient was experiencing nausea 1630: BP:118/68; P:72; RR:18; patient sitting in waiting area after receiving COVID-19 vaccine; stated she was fine but had some nausea; had eaten at ~1100 today and feeling fine; stated hx of Lupus and gave names of meds she had taken earlier; stated she had been cleared to receive vaccine by PCP and Rheumatologist 1635: BP:140/88; P:68; RR:18; patient began to slump down on chair and left hand began to go limp - 911 activated. Patient did not have LOC and tears rolled down her eyes; began to lose color on face; patient placed on cot in supine position and removed jacket she was wearing. Skin was warm but not clammy/diaphoretic. 1640:BP: 122/82; P:68; RR:18; patient lucid but began to slur words - continued to monitor, airway in tact and no LOC 1642: EMS arrival, report given to EMS and care transferred Blood sugar p/EMS: 80 1707: EMS departed, patient remained supine in cot; this nurse assisted patient from cot to a chair and patient did great. ~1720: Patient and her mom were escorted to her vehicle by another nurse 2013: This nurse called patient and she sounded wonderful; stated she was about to get showered; patient appreciative for f/u call.

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Symptoms

Hypotonia, Pallor, Nausea, Dysarthria, Skin warm, Blood glucose normal, Lacrimation increased, Altered state of consciousness

Vaccines

VAX DATE: 12-30-2020| ONSET DATE: 12-30-2020| DAYS TO ONSET: 0
NameDose #TypeManufacturerLotRouteSite
COVID19 (COVID19 (MODERNA)) 1 COVID19 MODERNA 025L20A IM LA

RECVDATE:12-30-2020
RPT_DATE:
CAGE_YR:52
CAGE_MO:
DIED:U
DATEDIED:
L_THREAT:U
ER_VISIT:
HOSPITAL:U
HOSPDAYS:
X_STAY:U
DISABLE:U
RECOVD:Y
LAB_DATA:
V_ADMINBY:PUB
OTHER_MEDS:Hydroxychloroquine 400mg daily Dolamide 300mg daily Vitamin D daily
CUR_ILL:
HISTORY:Lupus
PRIOR_VAX:
SPLTTYPE:
FORM_VERS:
TODAYS_DATE:12-30-2020
BIRTH_DEFECT:U
OFC_VISIT:U
ER_ED_VISIT:U
ALLERGIES:NKA
V_FUNDBY:

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