VAERS ID: 923791

AGE: 80| SEX: F|STATE: TN (United States)

Description

12/30/2020 around 2:00 nausea, vomitting, diarrhea, and chills started. Insomnia x3 days. Patient states she felt "wired and worked up". Noises made her anxious. Patient states "everything smelled bad". Patient had hallucinations seeing the devil and satanic thoughts 12/31/2020 to 1/4/2021 when patient finally fell asleep. 1/5/21 patient woke up with a headache and took ibuprofen and used a heating pad with relief. Patient took melatonin 1/5/21 before bed to go to sleep. Diarrhea stopped 12/31/20. Nausea stopped 1/5/21.Vomitting stopped 12/31/2020. Chills stopped 1/5/21. Patient has been eating bananas and chicken noodle soup and drinking sweet tea. Patient not as nervous 1/6/21 when she woke up.

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Symptoms

Chills, Headache, Vomiting, Insomnia, Nausea, Diarrhoea, Thinking abnormal, Anxiety, Parosmia, Blood test, Urine analysis, Hallucination, visual

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:01-06-2021
RPT_DATE:
CAGE_YR:80
CAGE_MO:
DIED:U
DATEDIED:
L_THREAT:U
ER_VISIT:
HOSPITAL:U
HOSPDAYS:
X_STAY:U
DISABLE:U
RECOVD:N
LAB_DATA:Urine and bloodwork done at emergency room on 1/4/21. Patient unsure of what tests were ran.
V_ADMINBY:PUB
OTHER_MEDS:Theophylline, Acyclovir, Gabapentin, Sertraline HCL, Lorazepam, Azithromycin, Famotidine , Zinc, Vitamin C
CUR_ILL:None
HISTORY:Legally blind, lung cancer in remission in 5 years, colon cancer in remission for 4 years, diverticulosis, COPD, emphysema
PRIOR_VAX:
SPLTTYPE:
FORM_VERS:
TODAYS_DATE:01-06-2021
BIRTH_DEFECT:U
OFC_VISIT:U
ER_ED_VISIT:Y
ALLERGIES:None
V_FUNDBY:

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