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Report #2844073

Received Jun 5, 2025

ER / ED visitOffice visit
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
Female
Age
73 yrs
State
OK
Recovered
Not recovered
Vaccinated
Dec 7, 2021
Onset
Dec 7, 2021
Days to onset
0
Hospital days
—

Vaccines (1)

TypeNameManufacturerDoseLotRoute / Site
COVID19COVID19 (COVID19 (MODERNA))MODERNA3O32H21ASYR / LA

Symptoms (5)

AmnesiaCraniofacial fractureFallShoulder fractureWrist fracture

Symptom narrative

I was in town for the booster, we were exiting the expo for Christmas. I had been standing for a hour and all i could remember was exiting on the east side holding the door open with my right hand, i don't remember my head turning around or anything i woke up in an ambulance with them asking who should we contact. And then i kinda don't remember too much of anything until i was in the exam room , my glasses were knocked off my shoe was knocked off and it was on concrete and i had tripped over that concrete bumper and there was a brick wall behind it 2.5 feet away and i was laying between the both i had fallen on my left side. I broke my shoulder and my wrist and the left side of my face. I went to see a facial surgeon and my doctor and i got an eye exam done.

Current illness

No

Medical history

No

Other medications

Multivitamin , Vitamin D

Allergies

No