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This is VAERS ID 1331030

History of Changes from the VAERS Wayback Machine

First Appeared on 5/28/2021

VAERS ID: 1331030
VAERS Form:2
Age:18.0
Sex:Female
Location:New York
Vaccinated:2021-05-19
Onset:2021-05-19
Submitted:0000-00-00
Entered:2021-05-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

Administered by: Public      Purchased by: ??
Symptoms: Injection site pruritus, 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:
Current Illness:
Preexisting Conditions:
Allergies: NKA
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Client C/O itchiness at injection site and left index finger. Full body assessment done, ice pack provided, 3 sets of vital signs done. At 2:56 pm client took Benadryl 25 mg, p.o. At 3:20pm client denied any itchiness, no acute distress, leave vaccination site at with daughter and mother. Provided client with education to be alert to any respiratory issues and seek 911 if in respiratory distress.

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