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This is VAERS ID 1261779

History of Changes from the VAERS Wayback Machine

First Appeared on 5/7/2021

VAERS ID: 1261779
VAERS Form:2
Age:51.0
Sex:Female
Location:California
Vaccinated:2021-04-07
Onset:2021-04-19
Submitted:0000-00-00
Entered:2021-04-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 038B21A / 1 LA / IM

Administered by: Other      Purchased by: ??
Symptoms: Injection site erythema, Injection site pruritus

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: none
Current Illness: none
Preexisting Conditions: none
Allergies: allergic to alcohol, cats, horses
Diagnostic Lab Data: none
CDC 'Split Type':

Write-up: 12 days after receiving the vaccine, I noticed a red oval/circle mark around the injection site. (otherwise known as "covid arm") I also noticed that my left arm was a little itchy as well. The redness went away after 4-5 days.


Changed on 5/14/2021

VAERS ID: 1261779 Before After
VAERS Form:2
Age:51.0
Sex:Female
Location:California
Vaccinated:2021-04-07
Onset:2021-04-19
Submitted:0000-00-00
Entered:2021-04-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 038B21A / 1 LA / IM

Administered by: Other      Purchased by: ??
Symptoms: Injection site erythema, Injection site pruritus

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: none
Current Illness: none
Preexisting Conditions: none
Allergies: allergic to alcohol, cats, horses horses
Diagnostic Lab Data: none
CDC 'Split Type':

Write-up: 12 days after receiving the vaccine, I noticed a red oval/circle mark around the injection site. (otherwise known as "covid arm") I also noticed that my left arm was a little itchy as well. The redness went away after 4-5 days.

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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1261779&WAYBACKHISTORY=ON


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