VAERS ID: 1415059

AGE: 0.25| SEX: F|STATE: PA

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.

Symptoms

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

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:U
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:2
TODAYS_DATE:06-21-2021
BIRTH_DEFECT:U
OFC_VISIT:Y
ER_ED_VISIT:Y
ALLERGIES:No
V_FUNDBY:

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