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This is VAERS ID 1368707

History of Changes from the VAERS Wayback Machine

First Appeared on 6/4/2021

VAERS ID: 1368707
VAERS Form:2
Age:39.0
Sex:Female
Location:California
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 O36C21A / 2 LA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Back pain, Chills, Fatigue, Feeling cold, Headache, Lymphadenopathy, Nausea, Pain, Pyrexia, Sinus congestion

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: Multi vitamins Digestive enzymes Biotin Vitamin c Vitamin d
Current Illness: HSV-2
Preexisting Conditions: Hsv - 2
Allergies: Eurythromicin Dairy Almonds
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pain in every tissue and bone of my body. Cold to the bone. Shivering, often uncontrollable. Temperature of 101.6. Intense nausea - kept thinking I was going to vomit. Tummy felt like I was going to have diarrhea so kept running to the toilet, but nothing happened. Swollen throat glands. Intense back pain. Head feels like it?s in a vice. Congestion in sinuses. Intense fatigue.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1368707&WAYBACKHISTORY=ON


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