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From the 6/4/2021 release of VAERS data:

This is VAERS ID 1262129



Case Details

VAERS ID: 1262129 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-09
Onset:2021-04-12
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-04-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 039821A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: amlodipine 5mg daily, benazepril 40mg daily, tamoxifen 20mg daily
Current Illness: urinary tract infection, candida vaginitis
Preexisting Conditions: hypertension, history of left breast carcinoma s/p left partial mastectomy w/ sentinel lymphadenopathy
Allergies: tramadol, acetaminophen, hydrocodone, oxycontin, norco, sulfa
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient reports hives occuring over all of her body about 3 days after receiving the Moderna COVID vaccine.


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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1262129


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