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Report #2844192

Received Jun 6, 2025

HospitalizedER / 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
Female
Age
48 yrs
State
KY
Recovered
Not recovered
Vaccinated
Aug 20, 2021
Onset
Sep 1, 2021
Days to onset
12
Hospital days
1

Vaccines (2)

TypeNameManufacturerDoseLotRoute / Site
COVID19COVID19 (COVID19 (MODERNA))MODERNA2053E21AIM / LA
COVID19COVID19 (COVID19 (MODERNA))MODERNA1078C21AIM / LA

Symptoms (11)

AngiogramArrhythmiaBradycardiaEchocardiogramElectrocardiogramElectrocardiogram ambulatoryImplantable cardiac monitor insertionSupraventricular extrasystolesTachycardiaUltrasound scanVentricular extrasystoles

Symptom narrative

Heart arrhythmia, PVC?s, PAC?s, tachycardia, bradycardia

Current illness

Asthma, fibromyalgia, IBS, GERD, homocysteinemia, APS

Medical history

Asthma, fibromyalgia, IBS, GERD, homocysteinemia, APS

Other medications

Singulair, folic acid, vitamin c, vitamin d3, vitamin b12, aspirin, ventolin HFA

Allergies

Penicillin, naproxen, naprosyn, cipro, sulpha drugs, cephalosporins, gabapentin, aloe, lanolin, latex, nectarines, figs, melons

Lab data

EKG?s, Internal Loop Recorder, Holter Monitor, Echo Cardiogram, Ultra sound, Angiogram CT scan