Report #2826406

Received Feb 15, 2025

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A note on interpretation. VAERS reports are unverified and may be incomplete or coincidental. A report does not establish that a vaccine caused an event, and counts should not be used to calculate incidence or infer causation. Full disclaimer

Overview

Sex: Male
Age: 45 yrs
State: VA
Recovered: Not recovered
Vaccinated: May 5, 2021
Onset: Aug 15, 2021
Days to onset: 102
Hospital days: —

Vaccines (3)

Type	Name	Manufacturer	Dose	Lot	Route / Site
COVID19	COVID19 (COVID19 (MODERNA))	MODERNA	2	004cz1a	SYR / AR
COVID19	COVID19 (COVID19 (MODERNA))	MODERNA	1	037b22a	SYR / AR
COVID19	COVID19 (COVID19 (MODERNA))	MODERNA	3	560421a	SYR / AR

Symptoms (2)

DizzinessVentricular extrasystoles

Symptom narrative

Lightheaded than developed pvcs

Current illness

None

Medical history

None

Other medications

None

Allergies

Davon darvacet

Lab data

Give permission to medical records upon followup