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This is VAERS ID 1371278

History of Changes from the VAERS Wayback Machine

First Appeared on 6/4/2021

VAERS ID: 1371278
VAERS Form:2
Age:21.0
Sex:Female
Location:Florida
Vaccinated:2021-06-03
Onset:2021-06-03
Submitted:0000-00-00
Entered:2021-06-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 036C21A / 2 LA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Hypoaesthesia, Nervousness, Tremor, Mobility decreased

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: N/A
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient received second Moderna vaccine. Was nervous, started shaking shortly after, than reported her arm started getting numb, and was having trouble lifting her arm. Her heart rate and BP was fine, no dizziness, SOB either. Told patient to go to walk in clinic/ urgent care for review

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