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This is VAERS ID 1149144

History of Changes from the VAERS Wayback Machine

First Appeared on 5/21/2021

VAERS ID: 1149144
VAERS Form:2
Age:29.0
Sex:Female
Location:Virginia
Vaccinated:2021-03-22
Onset:2021-03-25
Submitted:0000-00-00
Entered:2021-03-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Breast feeding

Life Threatening? No
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? No
Previous Vaccinations:
Other Medications: -wellbutrin -zoloft -prenatal vitamins -vitamin C -vitamin D
Current Illness: N/A
Preexisting Conditions: Migraines; anxiety; depression
Allergies: -Bactrum -gluten -pineapple
Diagnostic Lab Data: Visit to the pediatrician - 3/29/2021 (7 days after the vaccine was administered) -Visit determined that the 15-month-old had an ear infection and required antibiotics
CDC 'Split Type':

Write-up: The patient who received the vaccine was a breastfeeding mother. Her 15-month-old developed an ear infection, requiring antibiotics for the first time ever, within 72 hours of the vaccine administration. Her 15-month-old developed a fever of 102.6 approximately 6 days after the vaccine was administered. He then was prescribed antibiotics 7 full days after the vaccine was administered to the mother.

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