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This is VAERS ID 1241337

History of Changes from the VAERS Wayback Machine

First Appeared on 4/30/2021

VAERS ID: 1241337
VAERS Form:2
Age:51.0
Sex:Female
Location:Oregon
Vaccinated:2021-04-14
Onset:2021-04-21
Submitted:0000-00-00
Entered:2021-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 027B21A / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Fatigue, Headache, Injection site erythema, Injection site induration, Injection site mass, Injection site pruritus, Pain in extremity

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: Lisinopril/HCTZ, Spironolactone, Prozac, Topamax, Benadryl, Trazadone
Current Illness: None
Preexisting Conditions: Hih blood pressure, depression
Allergies: None
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: Sore arm, headache, blood pressure on meds normally 110 over 65, a few hours after vaccine blood pressure 145 over 64, fatigue, all subsided after a few days, 1 week later hard lump at injection site about size of silver dollar that is red and itches.


Changed on 5/7/2021

VAERS ID: 1241337 Before After
VAERS Form:2
Age:51.0
Sex:Female
Location:Oregon
Vaccinated:2021-04-14
Onset:2021-04-21
Submitted:0000-00-00
Entered:2021-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 027B21A / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Fatigue, Headache, Injection site erythema, Injection site induration, Injection site mass, Injection site pruritus, Pain in extremity

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: Lisinopril/HCTZ, Spironolactone, Prozac, Topamax, Benadryl, Trazadone
Current Illness: None
Preexisting Conditions: Hih blood pressure, depression
Allergies: None None
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: Sore arm, headache, blood pressure on meds normally 110 over 65, a few hours after vaccine blood pressure 145 over 64, fatigue, all subsided after a few days, 1 week later hard lump at injection site about size of silver dollar that is red and itches.


Changed on 5/14/2021

VAERS ID: 1241337 Before After
VAERS Form:2
Age:51.0
Sex:Female
Location:Oregon
Vaccinated:2021-04-14
Onset:2021-04-21
Submitted:0000-00-00
Entered:2021-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 027B21A / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Fatigue, Headache, Injection site erythema, Injection site induration, Injection site mass, Injection site pruritus, Pain in extremity

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: Lisinopril/HCTZ, Spironolactone, Prozac, Topamax, Benadryl, Trazadone
Current Illness: None
Preexisting Conditions: Hih blood pressure, depression
Allergies: None None
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: Sore arm, headache, blood pressure on meds normally 110 over 65, a few hours after vaccine blood pressure 145 over 64, fatigue, all subsided after a few days, 1 week later hard lump at injection site about size of silver dollar that is red and itches.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1241337&WAYBACKHISTORY=ON


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