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This is VAERS ID 1375041

History of Changes from the VAERS Wayback Machine

First Appeared on 6/11/2021

VAERS ID: 1375041
VAERS Form:2
Age:58.0
Sex:Female
Location:Illinois
Vaccinated:2021-06-01
Onset:2021-06-01
Submitted:0000-00-00
Entered:2021-06-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 038C21A / 2 RA / SYR

Administered by: Other      Purchased by: ??
Symptoms: Chills, Dizziness, Pain, Pyrexia, Mobility decreased

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: Zinc, Zyrtec
Current Illness: None
Preexisting Conditions: Asthma
Allergies: None
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Within an hour I was light headed, followed by extreme aches and fever, then chills. Unable to get out of bed. 60 hours duration.

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