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This is VAERS ID 1368815

History of Changes from the VAERS Wayback Machine

First Appeared on 6/4/2021

VAERS ID: 1368815
VAERS Form:2
Age:61.0
Sex:Female
Location:Arizona
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 005C214 / 2 LA / IM

Administered by: Other      Purchased by: ??
Symptoms: Incontinence, Pollakiuria

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: 1 per day: aspirin 81 mg, trazadone 75mg, escitalopram 20 mg (am), escitalopram 10 mg (pm), oxybutynin 10 mg, metoprolol 100 mg, losartan 50 mg, hidroclorotiazida 12.5 mg 2 per day: omeprazole 20 mg,
Current Illness: none
Preexisting Conditions: over-active bladder, depression, high blood pressure, gastric by-pass,
Allergies: codeine
Diagnostic Lab Data: none
CDC 'Split Type':

Write-up: Sudden frequent urination and incontinence post 4 hours after 2nd dose. Continuing through next day post injection. Currently unresolved.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1368815&WAYBACKHISTORY=ON


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