Report #2859822

Received Sep 18, 2025

Office 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: Male
Age: 41 yrs
State: NH
Recovered: Not recovered
Vaccinated: Jan 5, 2021
Onset: Aug 1, 2021
Days to onset: 208
Hospital days: —

Vaccines (2)

Type	Name	Manufacturer	Dose	Lot	Route / Site
COVID19	COVID19 (COVID19 (MODERNA))	MODERNA	1	039K 20A	IM / LA
COVID19	COVID19 (COVID19 (MODERNA))	MODERNA	2	028L 20A	IM / LA

Symptoms (3)

ElectrocardiogramLaboratory testVentricular extrasystoles

Symptom narrative

Constant Intermittent Premature ventricular contractions

Current illness

None

Medical history

None

Other medications

None

Allergies

None

Lab data

12 lead EKG, labs

Prior vaccinations

Anthrax, 21 y/o, each series of immunizations I became sick with fever, headache, sweats, fatigue, and tachycardia for 2 weeks