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This is VAERS ID 1369063

History of Changes from the VAERS Wayback Machine

First Appeared on 6/4/2021

VAERS ID: 1369063
VAERS Form:2
Age:48.0
Sex:Female
Location:Ohio
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 036C21A / 2 LA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Rash

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:
Current Illness:
Preexisting Conditions:
Allergies: NKA
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient experience entire body rash 6-8 hours after second dose of Moderna COVID vaccine. Patient self treated with oral Benadryl. Symptoms did improve with Benadryl therapy. Slight rash still evident on 6-2-21

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1369063&WAYBACKHISTORY=ON


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