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This is VAERS ID 1020671

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History of Changes from the VAERS Wayback Machine

First Appeared on 2/18/2021

VAERS ID: 1020671
VAERS Form:2
Age:41.0
Sex:Female
Location:Alaska
Vaccinated:2021-02-04
Onset:2021-02-06
Submitted:0000-00-00
Entered:2021-02-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011L20A / 2 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Ecchymosis, Epistaxis, Erythema, Haematocrit normal, Haemoglobin normal, Mouth haemorrhage, Petechiae, Platelet count decreased, White blood cell count normal, Metabolic function test normal, Coagulation test normal, Tongue erythema

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Vitamin D
Current Illness: None
Preexisting Conditions: Psoriasis
Allergies: Septra and erythromycin ointment
Diagnostic Lab Data: 2/9/21: platelets of 2.
CDC 'Split Type':

Write-up: 41 year old female received Moderna vaccine on 1/8/2021 (lot 011J20A) and 2/4/2021(lot 011 L20A) . About 2 days post vaccination noted small red spots on her tongue, arms and legs. On 6 days post vaccination she noticed a red mark on her neck and had prolonged epistaxis. She had a normal hemocue in the clinic and normal vital signs with no further bleeding. She was sent to the Emergency Department via chartered flight. In the ED she was noted to have a petechial rash of mucous membranes, upper and lower extremities and multiple ecchymosis. Her platelet count was 2. Hemoglobin 13.3, hematocrit 40.2%, WBC 7.86. Metabolic panel unremarkable, coagulation studies unremarkable. Vital signs normal. After consultation with hematology, Dr., she was given high dose steroids and tranexamic acid and sent via medevac to MC for possible IV Ig and platelet transfusion. She arrived there sometime early this morning. Platelets were 4 upon arrival at Medical Center.


Changed on 5/7/2021

VAERS ID: 1020671 Before After
VAERS Form:2
Age:41.0
Sex:Female
Location:Alaska
Vaccinated:2021-02-04
Onset:2021-02-06
Submitted:0000-00-00
Entered:2021-02-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011L20A / 2 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Ecchymosis, Epistaxis, Erythema, Haematocrit normal, Haemoglobin normal, Mouth haemorrhage, Petechiae, Platelet count decreased, White blood cell count normal, Metabolic function test normal, Coagulation test normal, Tongue erythema

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Vitamin D
Current Illness: None
Preexisting Conditions: Psoriasis
Allergies: Septra and erythromycin ointment ointment
Diagnostic Lab Data: 2/9/21: platelets of 2.
CDC 'Split Type':

Write-up: 41 year old female received Moderna vaccine on 1/8/2021 (lot 011J20A) and 2/4/2021(lot 011 L20A) . About 2 days post vaccination noted small red spots on her tongue, arms and legs. On 6 days post vaccination she noticed a red mark on her neck and had prolonged epistaxis. She had a normal hemocue in the clinic and normal vital signs with no further bleeding. She was sent to the Emergency Department via chartered flight. In the ED she was noted to have a petechial rash of mucous membranes, upper and lower extremities and multiple ecchymosis. Her platelet count was 2. Hemoglobin 13.3, hematocrit 40.2%, WBC 7.86. Metabolic panel unremarkable, coagulation studies unremarkable. Vital signs normal. After consultation with hematology, Dr., she was given high dose steroids and tranexamic acid and sent via medevac to MC for possible IV Ig and platelet transfusion. She arrived there sometime early this morning. Platelets were 4 upon arrival at Medical Center.


Changed on 5/21/2021

VAERS ID: 1020671 Before After
VAERS Form:2
Age:41.0
Sex:Female
Location:Alaska
Vaccinated:2021-02-04
Onset:2021-02-06
Submitted:0000-00-00
Entered:2021-02-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011L20A / 2 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Ecchymosis, Epistaxis, Erythema, Haematocrit normal, Haemoglobin normal, Mouth haemorrhage, Petechiae, Platelet count decreased, White blood cell count normal, Metabolic function test normal, Coagulation test normal, Tongue erythema

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Vitamin D
Current Illness: None
Preexisting Conditions: Psoriasis
Allergies: Septra and erythromycin ointment ointment
Diagnostic Lab Data: 2/9/21: platelets of 2.
CDC 'Split Type':

Write-up: 41 year old female received Moderna vaccine on 1/8/2021 (lot 011J20A) and 2/4/2021(lot 011 L20A) . About 2 days post vaccination noted small red spots on her tongue, arms and legs. On 6 days post vaccination she noticed a red mark on her neck and had prolonged epistaxis. She had a normal hemocue in the clinic and normal vital signs with no further bleeding. She was sent to the Emergency Department via chartered flight. In the ED she was noted to have a petechial rash of mucous membranes, upper and lower extremities and multiple ecchymosis. Her platelet count was 2. Hemoglobin 13.3, hematocrit 40.2%, WBC 7.86. Metabolic panel unremarkable, coagulation studies unremarkable. Vital signs normal. After consultation with hematology, Dr., she was given high dose steroids and tranexamic acid and sent via medevac to MC for possible IV Ig and platelet transfusion. She arrived there sometime early this morning. Platelets were 4 upon arrival at Medical Center.

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