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This is VAERS ID 1314096

History of Changes from the VAERS Wayback Machine

First Appeared on 5/21/2021

VAERS ID: 1314096
VAERS Form:2
Age:18.0
Sex:Male
Location:Iowa
Vaccinated:2021-05-03
Onset:2021-05-04
Submitted:0000-00-00
Entered:2021-05-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 006C21A / 2 RA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Epistaxis

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: loratadine, l-lysine
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient has a history of occasional nose bleeds, however after receiving 2nd Moderna vaccine he is experiencing nose bleeds every other day lasting $g20 minutes.

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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1314096&WAYBACKHISTORY=ON


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