|
| VAERS ID: |
1395518 (history) |
| Form: |
Version 2.0 |
| Age: |
42.0 |
| Sex: |
Male |
| Location: |
Unknown |
| Vaccinated: | 2020-12-23 |
| Onset: | 2020-12-30 |
| Days after vaccination: | 7 |
| Submitted: |
0000-00-00 |
| Entered: |
2021-01-09 |
| Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
| COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA |
039K20A / 1 |
LA / IM |
Administered by: Other Purchased by: ?
Symptoms: Bell's palsy,
Facial paralysis,
Headache
SMQs:, Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Hearing impairment (broad)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:
Write-up: Headache On Jan 1, 2021 10:00 had facial droop with headache, went to ED Narrative: went to ED Jan 1 after onset of facial droop with headache around 10:00am, diagnosed with Bell''s Palsy, treated with Toradol, Acyclovir, Benadryl and 7 day course of Prednisone 60mg daily and acyclovir 1000mg q8 hours x 7 days |
|
| VAERS ID: |
932948 (history) |
| Form: |
Version 2.0 |
| Age: |
40.0 |
| Sex: |
Male |
| Location: |
Kansas |
| Vaccinated: | 2020-12-27 |
| Onset: | 2020-12-28 |
| Days after vaccination: | 1 |
| Submitted: |
0000-00-00 |
| Entered: |
2021-01-10 |
| Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
| COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA |
011J20A / 1 |
LA / IM |
Administered by: Private Purchased by: ?
Symptoms: Bell's palsy,
Computerised tomogram head,
Laboratory test normal
SMQs:, Hearing impairment (broad)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Labs and CT scan of brain normal.
CDC Split Type:
Write-up: Bells Palsy approximately 24 hours after vaccination. I presented to the ER for evaluation. I was treated with steroids and antivirals for 7 days. Symptoms ave still persisted to date. |
|
| VAERS ID: |
933771 (history) |
| Form: |
Version 2.0 |
| Age: |
39.0 |
| Sex: |
Female |
| Location: |
New Jersey |
| Vaccinated: | 2021-01-07 |
| Onset: | 2021-01-07 |
| Days after vaccination: | 0 |
| Submitted: |
0000-00-00 |
| Entered: |
2021-01-11 |
| Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
| COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA |
011J20A / 1 |
LA / IM |
Administered by: Private Purchased by: ?
Symptoms: Bell's palsy,
Facial paralysis,
Paraesthesia oral
SMQs:, Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Hearing impairment (broad)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: None
Preexisting Conditions: Cervicalgia ? DJD (degenerative joint disease) of cervical spine ? Obesity ? Paresthesia and pain of both upper extremities
Allergies: NKDA
Diagnostic Lab Data: 1/8 CT HEAD
CDC Split Type:
Write-up: 1/7- RECEIVED VACCINE AND REPORTED HAVING TINGLING TO LIPS (A FEW HOURS LATER), TOOK BENADRYL AND REPORTED THAT TINGLING WENT AWAY. 1/8- REPORTED TINGLING TO LEFT OUTERLIP AND AND WENT TO ER AND DIAGNOSED WITH BELL PALSY / FACIAL PARALYSIS AFTER EVALUATION |
|
| VAERS ID: |
934236 (history) |
| Form: |
Version 2.0 |
| Age: |
65.0 |
| Sex: |
Female |
| Location: |
Georgia |
| Vaccinated: | 2021-01-06 |
| Onset: | 2021-01-07 |
| Days after vaccination: | 1 |
| Submitted: |
0000-00-00 |
| Entered: |
2021-01-11 |
| Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
| COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA |
IIL20A / 1 |
LA / IM |
Administered by: Private Purchased by: ?
Symptoms: Bell's palsy,
Paraesthesia,
Paraesthesia oral
SMQs:, Peripheral neuropathy (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Hearing impairment (broad)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: zocor, voltaren, jardiance, levothyroxine, zyrtec, pro-biotic, metformin, vitamin B complex, chromium picolinate, senior multivitamin, vitamin D3 , vitamin C, natural sambucus elderberry [3-way immune support]
Current Illness: covid-19: December 6, 2020
Preexisting Conditions: NIDDM, OA-bilateral knees, BMI-29.0, hypothyroidism
Allergies: aspirin, ultram, visine opth drops,claritin
Diagnostic Lab Data:
CDC Split Type:
Write-up: First began tingling on left side of forehead, then 4 hours later left temple then 6 hours later left side of lower lip and 1-2 hours later top of left cheek. [left side of jaw/ear lobe/half of cheek decreased sensation from prior surgery to remove parotid tumor since Nov. 1992] By 30 hours after vaccination I had received solu medrol and valtrex for early s/s of Bell''s palsy by hospitalist at hospital. All symptoms resolved by 1/9/21 pm. |
|
| VAERS ID: |
934289 (history) |
| Form: |
Version 2.0 |
| Age: |
63.0 |
| Sex: |
Female |
| Location: |
West Virginia |
| Vaccinated: | 2020-12-23 |
| Onset: | 2021-01-02 |
| Days after vaccination: | 10 |
| Submitted: |
0000-00-00 |
| Entered: |
2021-01-11 |
| Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
| COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA |
011J20A / 1 |
LA / IM |
Administered by: Private Purchased by: ?
Symptoms: Bell's palsy,
Eye pain,
Facial paralysis,
Full blood count normal,
Headache,
Hypoaesthesia oral
SMQs:, Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Glaucoma (broad), Hearing impairment (broad)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: HCTZ, AMITRIPTYLINE, ELIQUIS, CYMBALTA, ESTRAGEN PATCH, PROAIR AS NEEDED, CINNAMON, NIAGEN, FIBER, MAGNESIUM, PROBIOTICS, QUNOL, SUNFLOWER LECITHIN, VITAMIN D3, ZINC
Current Illness: NONE
Preexisting Conditions: HTN, HASHIMOTOS THYROIDITIS, HYDRENITIS SUPPORATIVA, ARTHRITIS
Allergies: DEMEROL, PERCOCET, WELLBUTRIN, CELEBREX, GABAPENTIN, NSAIDS
Diagnostic Lab Data: CBC - NORMAL, LYME TITER - PENDING
CDC Split Type:
Write-up: JAN2-HEADACHE, JAN 3 RIGHT SIDE OF TONGUE BECAME NUMB, AND JAN 4 RIGHT SIDE OF MOUTH BECAME NUMB, RIGHT EYE PAIN WITH TEARING, NOTICABLE DROOPING RIGHT SIDE OF FACE, MINIMAL ACTIVE MOVEMENT, FLUIDS DRIBBLED OUT OF RIGHT SIDE OF MOUTH WHEN DRINKING LIQUIDS, EVALUATED BY PA ON 1/5, DIAGNOSED WITH BELL''S PALSY, STARTED ON VALACYCLOCIR 1 GM THREE TIMES A DAY AND PREDNISONE TAPER BEGINNING WITH 60 MG X 5 DAYS AND TAPERING DOWNWARD |
|
| VAERS ID: |
934419 (history) |
| Form: |
Version 2.0 |
| Age: |
77.0 |
| Sex: |
Male |
| Location: |
Louisiana |
| Vaccinated: | 2021-01-06 |
| Onset: | 2021-01-07 |
| Days after vaccination: | 1 |
| Submitted: |
0000-00-00 |
| Entered: |
2021-01-11 |
| Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
| COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA |
027L20A / 1 |
LA / IM |
Administered by: Pharmacy Purchased by: ?
Symptoms: Bell's palsy
SMQs:, Hearing impairment (broad)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: NKDA
Diagnostic Lab Data:
CDC Split Type:
Write-up: BELL''S PALSY. |
|
| VAERS ID: |
935995 (history) |
| Form: |
Version 2.0 |
| Age: |
53.0 |
| Sex: |
Female |
| Location: |
Georgia |
| Vaccinated: | 2021-01-07 |
| Onset: | 2021-01-09 |
| Days after vaccination: | 2 |
| Submitted: |
0000-00-00 |
| Entered: |
2021-01-11 |
| Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
| COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA |
011L20A / 1 |
LA / IM |
Administered by: Private Purchased by: ?
Symptoms: Bell's palsy,
Pruritus,
Swelling face
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hearing impairment (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Outpatient Medications at End of Encounter on as of 1/7/2021 Disp Refills Start End hydroCHLOROthiazide (ESIDRIX/HYDRODIURIL) 25 mg Oral Tab 90 tablet 0/2 3/12/2020 3/12/2021 Sig - Route: Take 1 tablet by mouth every morning - Oral Renewa
Current Illness: as of 1/7/2021 ICD-10-CM Priority Class Noted - Resolved BLOOD PRESSURE ELEVATION R03.0 9/19/2017 - Present RIGHT BENIGN PAROXYSMAL POSITIONAL VERTIGO H81.11 4/25/2018 - Present LEFT VESTIBULAR FUNCTION DISORDER H81.92 5/18/2018 - Present HX OF TOTAL HYSTERECTOMY (Chronic) Z90.710 4/16/2019 - Present Overview TAH + BSO CORONAVIRUS COVID-19 DISEASE U07.1 4/11/2020 - Present
Preexisting Conditions:
Allergies: Allergies as of 1/7/2021 Reviewed by Md on 4/11/2020 Severity Noted Reaction Type Reactions Lisinopril Not Specified 04/16/2019 ? Allergy Other cough
Diagnostic Lab Data:
CDC Split Type:
Write-up: The employee reports that she developed symptoms consistent with Bell''s Palsy about 48 hours after receiving the vaccine. She states that the left side of her face is swollen and itchy. The employee has been takin Benadryl every 4 hours to keep the swelling down. |
|
| VAERS ID: |
937299 (history) |
| Form: |
Version 2.0 |
| Age: |
28.0 |
| Sex: |
Female |
| Location: |
Maine |
| Vaccinated: | 2021-01-07 |
| Onset: | 2021-01-11 |
| Days after vaccination: | 4 |
| Submitted: |
0000-00-00 |
| Entered: |
2021-01-12 |
| Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
| COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA |
011L20A / UNK |
RA / IM |
Administered by: Work Purchased by: ?
Symptoms: Bell's palsy,
Pain in jaw
SMQs:, Hearing impairment (broad), Osteonecrosis (broad)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: unknown
Preexisting Conditions: none noted
Allergies: none
Diagnostic Lab Data: none
CDC Split Type:
Write-up: Jaw became sore 1/9/21 , went to ER on 1/11/21 after continued pain diagnosed with Bells Palsy. Given Medications : Acyclovir 800mg 5 times daily for 7 days, 60 mg prednisone with taper 10 days, Eye patch and Eye drops. |
|
| VAERS ID: |
937571 (history) |
| Form: |
Version 2.0 |
| Age: |
50.0 |
| Sex: |
Female |
| Location: |
Missouri |
| Vaccinated: | 2020-12-28 |
| Onset: | 2021-01-11 |
| Days after vaccination: | 14 |
| Submitted: |
0000-00-00 |
| Entered: |
2021-01-12 |
| Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
| COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA |
011J20A / 1 |
LA / IM |
Administered by: Pharmacy Purchased by: ?
Symptoms: Bell's palsy
SMQs:, Hearing impairment (broad)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:
Write-up: Patient developed Bells Palsy. |
|
| VAERS ID: |
937613 (history) |
| Form: |
Version 2.0 |
| Age: |
59.0 |
| Sex: |
Female |
| Location: |
Texas |
| Vaccinated: | 2021-01-04 |
| Onset: | 2021-01-05 |
| Days after vaccination: | 1 |
| Submitted: |
0000-00-00 |
| Entered: |
2021-01-12 |
| Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
| COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA |
025L20A / 1 |
LA / IM |
Administered by: Private Purchased by: ?
Symptoms: Bell's palsy,
Facial paralysis
SMQs:, Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Hearing impairment (broad)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Tdap in 2018 and small pox vaccine as a child
Other Medications: citalopram, restoril, norco
Current Illness: nausea, vomiting, diarrhea 12/15/2020
Preexisting Conditions: fibromyalgia, idiopathic autoimmune disease
Allergies: none
Diagnostic Lab Data: none
CDC Split Type:
Write-up: Pt states she awoke at 0600 01/05/2021 with right side facial paralysis Was seen by PA diagnosis with Bells Palsy was started on Prednisone 01/05/2021 |
|
