VAERS ID: 1415059

AGE: 0.25| SEX: F|STATE: PA (United States)

Description

I (mother of patient ) received the first dose of the Moderna vaccine on Friday June 18th at approximately 01:30pm. I fed my three month old daughter milk that I pumped from my breasts later that night and put her to bed. When transferring her to her bassinet at approximately 11:30pm, she started a seizure that lasted seven minutes. We were transported to Hospital where she suffered two more seizures in the early morning hours of June 19th. She has been a healthy baby with no health conditions prior to these events.

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Symptoms

Electroencephalogram normal, Computerised tomogram normal, Blood glucose normal, Lumbar puncture normal, Viral test negative, Bacterial test negative, Seizure, Exposure via breast milk, Magnetic resonance imaging normal

Vaccines

VAX DATE: 06-18-2021| ONSET DATE: 06-18-2021| DAYS TO ONSET: 0
NameDose #TypeManufacturerLotRouteSite
COVID19 (COVID19 (MODERNA)) 1 COVID19 MODERNA 051c21a SYR LA

RECVDATE:06-21-2021
RPT_DATE:
CAGE_YR:0
CAGE_MO:0.3
DIED:U
DATEDIED:
L_THREAT:U
ER_VISIT:
HOSPITAL:Y
HOSPDAYS:2
X_STAY:U
DISABLE:Y
RECOVD:U
LAB_DATA:Bacterial/viral tests came back negative June 21 Glucose came back negative June 19 Two EEG tests came back normal. June 19&20 MRI/CT scans came back normal. June 19th Spinal test came back normal. June 21
V_ADMINBY:PHM
OTHER_MEDS:No
CUR_ILL:No
HISTORY:No
PRIOR_VAX:
SPLTTYPE:
FORM_VERS:
TODAYS_DATE:06-21-2021
BIRTH_DEFECT:U
OFC_VISIT:Y
ER_ED_VISIT:Y
ALLERGIES:No
V_FUNDBY:

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