National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 1371982

History of Changes from the VAERS Wayback Machine

First Appeared on 6/4/2021

VAERS ID: 1371982
VAERS Form:2
Age:56.0
Sex:Female
Location:California
Vaccinated:2021-06-01
Onset:2021-06-01
Submitted:0000-00-00
Entered:2021-06-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 009C21A / UNK - / -

Administered by: Pharmacy      Purchased by: ??
Symptoms: Arthralgia, Atrial flutter, Chest discomfort, Chills, Dyspnoea, Hyperhidrosis, Joint swelling, Nausea, Oedema peripheral, Pollakiuria, Productive cough, Pyrexia, Swelling, Wheezing, Musculoskeletal stiffness, Oropharyngeal pain

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? Yes
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: 2012
Other Medications: None
Current Illness: Rheumatoid Arthritis, Asthma, Basilar Migraines.
Preexisting Conditions: Rheumatoid Arthritis, Asthma, Basilar Migraines
Allergies: Tetracycline, Codeine, nuts, casin, fermented food
Diagnostic Lab Data: None at this time.
CDC 'Split Type':

Write-up: Wheezing, productive cough, 102.2 fever, bilateral leg edema, joint pain with edema, shortness of breath, chills, urinating every 45min - 1hour, A-Flutter, tightness in chest and back, profuse sweating, sore throat, neck swelling, and nausea. Took otc pain reliever.

New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1371982&WAYBACKHISTORY=ON


Copyright © 2021 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166