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This is VAERS ID 1366592

History of Changes from the VAERS Wayback Machine

First Appeared on 6/4/2021

VAERS ID: 1366592
VAERS Form:2
Age:20.0
Sex:Female
Location:Oregon
Vaccinated:2021-06-01
Onset:2021-06-01
Submitted:0000-00-00
Entered:2021-06-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Unknown      Purchased by: ??
Symptoms: Injection site erythema, Injection site induration, Injection site pain, Injection site rash, Injection site warmth, Injection site swelling

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: Albuterol inhaler
Current Illness:
Preexisting Conditions: Hypoglycemia, asthma, PCOS
Allergies: All sulfa drugs
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Hardness at injection site, tenderness around entire shoulder, red splotchy rash, heat in rash, swelling. Started a couple of hours after vaccination

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1366592&WAYBACKHISTORY=ON


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