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This is VAERS ID 1240221

History of Changes from the VAERS Wayback Machine

First Appeared on 4/30/2021

VAERS ID: 1240221
VAERS Form:2
Age:41.0
Sex:Female
Location:Iowa
Vaccinated:2021-04-21
Onset:2021-04-21
Submitted:0000-00-00
Entered:2021-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Pharmacy      Purchased by: ??
Symptoms: Injection site induration, Pain in extremity, Injection site swelling

Life Threatening? No
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)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: IUD
Current Illness: None
Preexisting Conditions: None
Allergies: Tetracycline
Diagnostic Lab Data: None.
CDC 'Split Type':

Write-up: My arm is very swollen and hard (and hot) below the injection site. It is extremely painful.


Changed on 5/7/2021

VAERS ID: 1240221 Before After
VAERS Form:2
Age:41.0
Sex:Female
Location:Iowa
Vaccinated:2021-04-21
Onset:2021-04-21
Submitted:0000-00-00
Entered:2021-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Pharmacy      Purchased by: ??
Symptoms: Injection site induration, Pain in extremity, Injection site swelling

Life Threatening? No
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)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: IUD
Current Illness: None
Preexisting Conditions: None
Allergies: Tetracycline Tetracycline
Diagnostic Lab Data: None.
CDC 'Split Type':

Write-up: My arm is very swollen and hard (and hot) below the injection site. It is extremely painful.


Changed on 5/14/2021

VAERS ID: 1240221 Before After
VAERS Form:2
Age:41.0
Sex:Female
Location:Iowa
Vaccinated:2021-04-21
Onset:2021-04-21
Submitted:0000-00-00
Entered:2021-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Pharmacy      Purchased by: ??
Symptoms: Injection site induration, Pain in extremity, Injection site swelling

Life Threatening? No
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)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: IUD
Current Illness: None
Preexisting Conditions: None
Allergies: Tetracycline Tetracycline
Diagnostic Lab Data: None.
CDC 'Split Type':

Write-up: My arm is very swollen and hard (and hot) below the injection site. It is extremely painful.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1240221&WAYBACKHISTORY=ON


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