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This is VAERS ID 1372075

History of Changes from the VAERS Wayback Machine

First Appeared on 6/4/2021

VAERS ID: 1372075
VAERS Form:2
Age:29.0
Sex:Female
Location:Arkansas
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 - / 2 LA / SYR

Administered by: Pharmacy      Purchased by: ??
Symptoms: Feeling cold, Headache, Injection site erythema, Injection site induration, Injection site pain, Injection site pruritus, Injection site rash, Injection site reaction, Injection site warmth, Pain in extremity, Injection site swelling, Hot flush, Body temperature fluctuation

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: Pneumonia shot
Other Medications: Enbrel, cymbalta
Current Illness:
Preexisting Conditions: Fibromyalgia, psoriatic arthritis
Allergies: Penicillin, codeine, hydrocodone, nsaids, latex, bactrum
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Headache, arm pain, injection site swelling, site redness, site hardness, site pain, site itching, site rash

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1372075&WAYBACKHISTORY=ON


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