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This is VAERS ID 1371839

History of Changes from the VAERS Wayback Machine

First Appeared on 6/4/2021

VAERS ID: 1371839
VAERS Form:2
Age:52.0
Sex:Female
Location:Kentucky
Vaccinated:2021-05-21
Onset:2021-06-01
Submitted:0000-00-00
Entered:2021-06-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / IM

Administered by: Public      Purchased by: ??
Symptoms: Burning sensation, Pruritus, Rash macular

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: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: The patient states her arm that she received the vaccine in started itching on 6/1/2021 and has red blotches. She states it continues to itch and burn. Reports no open skin areas.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1371839&WAYBACKHISTORY=ON

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