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Report #2859967

Received Sep 19, 2025

ER / ED 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
30 yrs
State
NC
Recovered
Recovered
Vaccinated
Mar 10, 2021
Onset
Mar 11, 2021
Days to onset
1
Hospital days
—

Vaccines (1)

TypeNameManufacturerDoseLotRoute / Site
COVID19COVID19 (COVID19 (MODERNA))MODERNA2011A21ASYR / RA

Symptoms (43)

Alanine aminotransferase normalAlbumin globulin ratio increasedAspartate aminotransferase normalBasophil percentage decreasedBlood albumin normalBlood alkaline phosphatase normalBlood bilirubin normalBlood calcium normalBlood chloride normalBlood creatinine increasedBlood glucose normalBlood potassium normalBlood sodium normalBlood urea nitrogen/creatinine ratioBlood urea normalCarbon dioxideChillsDizzinessDyspnoeaEosinophil count decreasedEosinophil percentage decreasedFull blood countHaematocrit decreasedHaemoglobin decreasedImmature granulocyte countLymphocyte count decreasedMean cell haemoglobin concentration normalMean cell haemoglobin decreasedMean cell haemoglobin normalMean platelet volume increasedMonocyte count normalMonocyte percentageNauseaNeutrophil count increasedNeutrophil percentage increasedPlatelet count normalProtein total normalPyrexiaRed blood cell count decreasedRed blood cell nucleated morphologyRed cell distribution width increasedVomitingWhite blood cell count increased

Symptom narrative

Fever, Chills, Nausea, vomiting, dizziness, and shortness of breath

Current illness

None

Medical history

None

Other medications

Daily Vitamin

Allergies

None known

Lab data

Lab results: CBC AND DIFFERENTIAL - Abnormal Result Value WBC 11.7 (*) RBC 4.55 HGB 13.4 (*) HCT 39.2 (*) MCV 86 MCH 29.5 MCHC 34.2 Plt Ct 208 RDW SD 37.0 MPV 10.8 NRBC% 0.0 NRBC 0.000 NEUTROPHIL % 87.0 (*) LYMPHOCYTE % 5.6 (*) MONOCYTE % 6.5 Eosinophil % 0.3 (*) BASOPHIL % 0.3 IG% 0.300 ABSOLUTE NEUTROPHIL COUNT 10.15 (*) ABSOLUTE LYMPHOCYTE COUNT 0.7 (*) MONO ABSOLUTE 0.8 EOS ABSOLUTE 0.0 BASO ABSOLUTE 0.0 IG ABSOLUTE 0.040 (*) COMPREHENSIVE METABOLIC PANEL - Abnormal Na 140 Potassium 3.7 Cl 100 CO2 27 Glucose 105 (*) BUN 17 Creatinine 1.12 Ca 9.3 ALK PHOS 84 T Bili 0.71 Total Protein 7.2 Alb 4.6 GLOBULIN 2.6 ALBUMIN/GLOBULIN RATIO 1.8 BUN/CREAT RATIO 15.2 ALT 11 AST 17