VAERS ID: 942404

AGE: 41| SEX: M|STATE: NY (United States)

Description

About 5 hrs after receiving vaccine muscle ache in shoulder. Next day mild headache and body aches through day three. Slight sinus drainage on day 2 and 3 and tightness in chest on day 3 morning. Penis reduced in size, length, and circumference is significant since following day and pain in penal area from day 3 and day 5 most noticeable. Shape of penis has changed (noticed on day 4 due to an erection) and the skin has become loose with the size reduction (like baggy pants.)

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Symptoms

Myalgia, Headache, Pain, Erectile dysfunction, Penis disorder, Chest discomfort, Sinus disorder, Penile pain

Vaccines

VAX DATE: 01-09-2021| ONSET DATE: 01-10-2021| DAYS TO ONSET: 1
NameDose #TypeManufacturerLotRouteSite
COVID19 (COVID19 (MODERNA)) 1 COVID19 MODERNA 011J20A Unknown Unknown

RECVDATE:01-13-2021
RPT_DATE:
CAGE_YR:41
CAGE_MO:
DIED:U
DATEDIED:
L_THREAT:U
ER_VISIT:
HOSPITAL:U
HOSPDAYS:
X_STAY:U
DISABLE:U
RECOVD:N
LAB_DATA:Follow up with Dr?s visit
V_ADMINBY:PVT
OTHER_MEDS:Acetaminophen 325 mg, Aspirin 81 mg, Atorvastatatin 10 mg, Metformin HCL 1000 mg, Pioglitazone HCL 15 mg, Valsartan 80 mg, Omega 3, Biotin, Vitamin C, Zinc, multivitamin, cyclobenzapone 10 mg (only once for pain)
CUR_ILL:Diabetes
HISTORY:Diabetes
PRIOR_VAX:Pneumonia
SPLTTYPE:
FORM_VERS:
TODAYS_DATE:01-13-2021
BIRTH_DEFECT:U
OFC_VISIT:Y
ER_ED_VISIT:U
ALLERGIES:Sulfa, some high blood pressure medications
V_FUNDBY:

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