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Report #2872973

Received Nov 16, 2025

Life-threateningHospitalizedER / 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
Male
Age
27 yrs
State
FL
Recovered
Not recovered
Vaccinated
May 27, 2021
Onset
May 27, 2021
Days to onset
0
Hospital days
6

Vaccines (1)

TypeNameManufacturerDoseLotRoute / Site
COVID19COVID19 (COVID19 (MODERNA))MODERNA1—SYR / RA

Symptoms (27)

AmnesiaAppendicectomyBlood testBlood testosterone decreasedCholelithiasisColitisComputerised tomogram abdomenComputerised tomogram abdomen abnormalComputerised tomogram pelvisComputerised tomogram thoraxDisturbance in attentionDiverticulitisEchocardiogramEchocardiogram abnormalElectrocardiogram T wave abnormalFatigueGastritisGastrointestinal ulcerHepatic calcificationHepatic steatosisImpaired gastric emptyingMitral valve incompetenceMusculoskeletal stiffnessTricuspid valve incompetenceUltrasound abdomen abnormalUltrasound biliary tractWeight decreased

Symptom narrative

right ventricular delays, V1-V2, nodules right lobe #7, series 2, tricupsid/mitral regurgitation, T wave deviation, RSR V1-2, persistent memory loss/concentration (diverticulitis, ulcers, lesions, colitis, Gasteropersesis, gastritis,, gallbladder ,internal sludge, fatty liver with calcification - duct dilation, distal colon collapse. Appendectomy may 27 2021, same date as vaccine.

Current illness

Perfectly healthy.

Medical history

right ventricular delays, V1-V2, nodules right lobe #7, series 2, tricupsid/mitral regurgitation, T wave deviation, RSR V1-2, persistent memory loss/concentration (diverticulitis, ulcers, lesions, colitis, Gasteropersesis, gastritis,, gallbladder ,internal sludge, fatty liver with calcification - duct dilation, distal colon collapse, low testosterone, chronic fatigue, extreme weight loss. Neck/back stiffness. Disability application in progress. APPENDECTOMY same day from vaccine confirmed.

Other medications

Suboxone, clonazepam, clondidine

Allergies

Respiridone, mertazerpine

Lab data

Ekg heart , ct chest , pelvic , transthoracic echocardiogram, CT abdomen, ultrasound on gallbladder, appendix, . All May 27, 2021. All blood work was completed, effects shown about.