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This is VAERS ID 1053274

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History of Changes from the VAERS Wayback Machine

First Appeared on 3/5/2021

VAERS ID: 1053274
VAERS Form:2
Age:34.0
Sex:Female
Location:Alaska
Vaccinated:2021-02-12
Onset:2021-02-21
Submitted:0000-00-00
Entered:2021-02-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 013M20A / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: C-reactive protein normal, Full blood count, International normalised ratio normal, Platelet count decreased, Prothrombin time normal, Thrombocytopenia, Metabolic function test normal, Immune thrombocytopenia

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? Yes
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: daily MV
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: CBC with platelet count of 5, normal PT/INR, normal CMP, normal crp
CDC 'Split Type':

Write-up: thrombocytopenia, ITP


Changed on 5/7/2021

VAERS ID: 1053274 Before After
VAERS Form:2
Age:34.0
Sex:Female
Location:Alaska
Vaccinated:2021-02-12
Onset:2021-02-21
Submitted:0000-00-00
Entered:2021-02-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 013M20A / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: C-reactive protein normal, Full blood count, International normalised ratio normal, Platelet count decreased, Prothrombin time normal, Thrombocytopenia, Metabolic function test normal, Immune thrombocytopenia

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? Yes
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: daily MV
Current Illness: none
Preexisting Conditions: none
Allergies: none none
Diagnostic Lab Data: CBC with platelet count of 5, normal PT/INR, normal CMP, normal crp
CDC 'Split Type':

Write-up: thrombocytopenia, ITP


Changed on 5/21/2021

VAERS ID: 1053274 Before After
VAERS Form:2
Age:34.0
Sex:Female
Location:Alaska
Vaccinated:2021-02-12
Onset:2021-02-21
Submitted:0000-00-00
Entered:2021-02-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 013M20A / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: C-reactive protein normal, Full blood count, International normalised ratio normal, Platelet count decreased, Prothrombin time normal, Thrombocytopenia, Metabolic function test normal, Immune thrombocytopenia

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? Yes
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: daily MV
Current Illness: none
Preexisting Conditions: none
Allergies: none none
Diagnostic Lab Data: CBC with platelet count of 5, normal PT/INR, normal CMP, normal crp
CDC 'Split Type':

Write-up: thrombocytopenia, ITP

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