Received Oct 7, 2025
| Type | Name | Manufacturer | Dose | Lot | Route / Site |
|---|---|---|---|---|---|
| COVID19 | COVID19 (COVID19 (MODERNA)) | MODERNA | 1 | — | SYR / LA |
On 10\3\25 I had a COVID Vaccine (Moderna) at (withheld name) Pharmacy. On 10\4 I was disoriented and had severe memory loss one day after vaccine. I felt in a fog most of the day, but lost a complete period of time when my wife and I were giving a tour of the downstairs of our house to friends. I don't recall it at all. Also during that time, as my wife explained to them about concrete work for a patio we were planning out back I didn't know anything about this even though I had spray painted the outline on the ground and met with 3 contractors previously. In hindsight, we believe the same thing happened in 2020 (?) after the vaccine when I checked myself into the hospital for a heart problem and called my wife to ask her why I was there. I believe my wife brought this to Dr (withheld name attention when they were both in the hospital with me. I believe these incidents were possibly from autoimmune encephalitis. A Rare Adverse Effect of the COVID-19 Vaccine on Autoimmune Encephalitis (withheld)
For this event, I had a cold that started 1 week prior with a slight fever. Nothing else.
Mitral valve repair in 1996. 2020 A-Flutter and low EF.
ELIQUIS 5 MG 2x ENTRESTO 49 MG-51 MG 2x Nebivolol 5 mg 1x CARVEDILOL 6.25 MG 2x Rosuvastatin Calcium 20mg 1x Glucosamine Chondroitin
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Age 59. Same vaccine and same adverse event.