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This is VAERS ID 1235652

History of Changes from the VAERS Wayback Machine

First Appeared on 4/30/2021

VAERS ID: 1235652
VAERS Form:2
Age:48.0
Sex:Female
Location:Texas
Vaccinated:2021-04-06
Onset:2021-04-19
Submitted:0000-00-00
Entered:2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 01682119 / 1 LA / SYR

Administered by: Public      Purchased by: ??
Symptoms: Injection site erythema, Injection site pain, Injection site pruritus, Skin warm, Injection site swelling

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: Estradiol- 1mg twice a day Duloxetine- 60mg once a day Oxybutynin- 5mg once a day Lisinopril- 10mg once a day
Current Illness: NONE
Preexisting Conditions: NONE
Allergies: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up: Redness, soreness, itching, and slight swelling at injection point. Left upper arm with slight warmth.


Changed on 5/7/2021

VAERS ID: 1235652 Before After
VAERS Form:2
Age:48.0
Sex:Female
Location:Texas
Vaccinated:2021-04-06
Onset:2021-04-19
Submitted:0000-00-00
Entered:2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 01682119 / 1 LA / SYR

Administered by: Public      Purchased by: ??
Symptoms: Injection site erythema, Injection site pain, Injection site pruritus, Skin warm, Injection site swelling

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: Estradiol- 1mg twice a day Duloxetine- 60mg once a day Oxybutynin- 5mg once a day Lisinopril- 10mg once a day
Current Illness: NONE
Preexisting Conditions: NONE
Allergies: NONE NONE
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up: Redness, soreness, itching, and slight swelling at injection point. Left upper arm with slight warmth.


Changed on 5/14/2021

VAERS ID: 1235652 Before After
VAERS Form:2
Age:48.0
Sex:Female
Location:Texas
Vaccinated:2021-04-06
Onset:2021-04-19
Submitted:0000-00-00
Entered:2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 01682119 / 1 LA / SYR

Administered by: Public      Purchased by: ??
Symptoms: Injection site erythema, Injection site pain, Injection site pruritus, Skin warm, Injection site swelling

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: Estradiol- 1mg twice a day Duloxetine- 60mg once a day Oxybutynin- 5mg once a day Lisinopril- 10mg once a day
Current Illness: NONE
Preexisting Conditions: NONE
Allergies: NONE NONE
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up: Redness, soreness, itching, and slight swelling at injection point. Left upper arm with slight warmth.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1235652&WAYBACKHISTORY=ON


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