VAERS ID: 936865

AGE: 38| SEX: F|STATE: NY (United States)

Description

Mother; approximately 12 hrs after fever, chills for about 8 hours. Diarrhea 3 days. Mother is pumping breastmilk. Injection was Friday. 11 month old infant had Fridays milk on Sat, Sat milk on Sunday. Infant fatigued and fussy with loose stools Sunday. Infant had diarrhea, vomited and spiked 102.2 fever Monday evening 1/11. Fever broke Tuesday morning 7 am. Infant still fussy and loose stools. Vomiting ceased.

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Symptoms

Chills, Diarrhoea, Pyrexia

Vaccines

VAX DATE: 01-08-2021| ONSET DATE: 01-09-2021| DAYS TO ONSET: 1
NameDose #TypeManufacturerLotRouteSite
COVID19 (COVID19 (MODERNA)) 1 COVID19 MODERNA SYR LA

RECVDATE:01-12-2021
RPT_DATE:
CAGE_YR:38
CAGE_MO:
DIED:U
DATEDIED:
L_THREAT:U
ER_VISIT:U
HOSPITAL:U
HOSPDAYS:
X_STAY:U
DISABLE:U
RECOVD:Y
LAB_DATA:
V_ADMINBY:PUB
OTHER_MEDS:Sertraline 100mg daily, 1 prenatal daily
CUR_ILL:stomach bug 2 weeks prior breast feed infant side effects onset started Sunday 1/10/21 in the morning, fever spike 102.2 with ibuprophen 1/11/21 at 5pm infant is 11 months on 1/12./21
HISTORY:none for mother or infant
PRIOR_VAX:
SPLTTYPE:
FORM_VERS:2
TODAYS_DATE:01-12-2021
BIRTH_DEFECT:U
OFC_VISIT:U
ER_ED_VISIT:U
ALLERGIES:Peanuts, pecans, almonds
V_FUNDBY:

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