National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 1262161

History of Changes from the VAERS Wayback Machine

First Appeared on 5/7/2021

VAERS ID: 1262161
VAERS Form:2
Age:58.0
Sex:Female
Location:California
Vaccinated:2021-03-16
Onset:2021-04-19
Submitted:0000-00-00
Entered:2021-04-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 026B21A / 1 LA / IM

Administered by: Unknown      Purchased by: ??
Symptoms: Arthralgia, Dizziness, Fatigue, Herpes zoster, Neck pain, White blood cell count decreased, Skin weeping, Post-acute COVID-19 syndrome

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)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: yes
Current Illness: no
Preexisting Conditions: no
Allergies: no
Diagnostic Lab Data: low white blood cell counts
CDC 'Split Type':

Write-up: sore shoulder , tired, light headed, neck pain, shingles on neck, oozing from ears, eyes, mouth, covid toes


Changed on 5/14/2021

VAERS ID: 1262161 Before After
VAERS Form:2
Age:58.0
Sex:Female
Location:California
Vaccinated:2021-03-16
Onset:2021-04-19
Submitted:0000-00-00
Entered:2021-04-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 026B21A / 1 LA / IM

Administered by: Unknown      Purchased by: ??
Symptoms: Arthralgia, Dizziness, Fatigue, Herpes zoster, Neck pain, White blood cell count decreased, Skin weeping, Post-acute COVID-19 syndrome

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)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: yes
Current Illness: no
Preexisting Conditions: no
Allergies: no no
Diagnostic Lab Data: low white blood cell counts
CDC 'Split Type':

Write-up: sore shoulder , tired, light headed, neck pain, shingles on neck, oozing from ears, eyes, mouth, covid toes

New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1262161&WAYBACKHISTORY=ON


Copyright © 2021 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166