Report #2840062

Received May 8, 2025

Life-threateningHospitalizedER / ED visitOffice visitDisabled

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: 44 yrs
State: IN
Recovered: Not recovered
Vaccinated: Jan 1, 2021
Onset: Mar 1, 2021
Days to onset: 59
Hospital days: 5

Vaccines (1)

Type	Name	Manufacturer	Dose	Lot	Route / Site
COVID19	COVID19 (COVID19 (MODERNA))	MODERNA	2	—	SYR / LA

Symptoms (5)

ArrhythmiaCardiac monitoring abnormalCardiac ventricular thrombosisCatheterisation cardiac abnormalMyocardial infarction

Symptom narrative

Abnormal heart rhythm followed by a blood clot and heart attack.

Medical history

High cholesterol

Other medications

Omeprazole, multivitamin, fish oil

Allergies

Statins

Lab data

Heart monitor, heart catheter showing blood clot