National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 1347030

History of Changes from the VAERS Wayback Machine

First Appeared on 6/4/2021

VAERS ID: 1347030
VAERS Form:2
Age:47.0
Sex:Female
Location:Louisiana
Vaccinated:2021-05-20
Onset:2021-05-22
Submitted:0000-00-00
Entered:2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 036C21A / 2 RA / IM

Administered by: Private      Purchased by: ??
Symptoms: Injection site erythema, Injection site warmth

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: Immodopine 5mg, Cetirizine, Hormone replacement
Current Illness: Breast cancer
Preexisting Conditions: Breast cancer since 09/2020
Allergies: amoxicillin
Diagnostic Lab Data: n/a
CDC 'Split Type':

Write-up: Tissue reaction with redness and heat to area

New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1347030&WAYBACKHISTORY=ON


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