Report #2839141

Received May 1, 2025

Life-threateningHospitalizedER / ED visit

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Overview

Sex: Female
Age: 20 yrs
State: OR
Recovered: Recovered
Vaccinated: Apr 28, 2025
Onset: Apr 28, 2025
Days to onset: 0
Hospital days: 2

Vaccines (1)

Type	Name	Manufacturer	Dose	Lot	Route / Site
COVID19	COVID19 (COVID19 (MODERNA))	MODERNA	N/A	3044069	IM / LA

Symptoms (6)

DisorientationDizzinessLoss of consciousnessPain in extremityPyrexiaUrticaria

Symptom narrative

4/28/2025 at 0830 Moderna COVID-19 Spikevax administered to L deltoid. Later that same day L arm soreness developed with progression to fever in the evening. 4/29/2025 at 0500 woke feeling lightheaded, disoriented, blacking out with hives present on L wrist. At 0700 woke for work- hives present systemically. Presented to urgent care and was directed to the ED. Caregiver reports passing out at check-in. Admitted through ED for 1 night observation.

Current illness

unknown

Medical history

none reported

Other medications

unknown. Employee did not divulge this information to the occupational health clinic.

Allergies

none.

Lab data

details unknown. Caregiver evaluated in ED, administered epi and Benadryl. Admitted overnight on telemetry observation unit.