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This is VAERS ID 1350345

History of Changes from the VAERS Wayback Machine

First Appeared on 6/4/2021

VAERS ID: 1350345
VAERS Form:2
Age:58.0
Sex:Female
Location:Oklahoma
Vaccinated:2021-05-20
Onset:2021-05-22
Submitted:0000-00-00
Entered:2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 006M20A / 1 LA / IM

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

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)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: cholecalciferol 2000IU daily, gabapentin 900mg tablet daily prn, loratadine 10mg daily prn, OTC calcium
Current Illness: N/a
Preexisting Conditions: Fibromyalgia, h/o deep vein thrombosis, allergic rhinitis, vitamin d deficiency
Allergies: robitussin DM, bactrim
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Redness of the left upper extremity site starting 2 days after vaccine, initially with associated soreness and pain that resolved w/in 48 hours, but redness persisting and spreading distally.

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