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This is VAERS ID 1301988

History of Changes from the VAERS Wayback Machine

First Appeared on 5/21/2021

VAERS ID: 1301988
VAERS Form:2
Age:37.0
Sex:Female
Location:California
Vaccinated:2021-05-02
Onset:2021-05-02
Submitted:0000-00-00
Entered:2021-05-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 003C21A / 1 LA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Eye swelling, Nausea, Swelling face, Swollen tongue, Vomiting

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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Systemic: Allergic: Swelling of Face / Eyes / Mouth / Tongue-Mild, Systemic: Nausea-Medium, Systemic: Vomiting-Medium

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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1301988&WAYBACKHISTORY=ON


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