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This is VAERS ID 1376031

History of Changes from the VAERS Wayback Machine

First Appeared on 6/11/2021

VAERS ID: 1376031
VAERS Form:2
Age:21.0
Sex:Male
Location:Pennsylvania
Vaccinated:2021-06-03
Onset:2021-06-04
Submitted:0000-00-00
Entered:2021-06-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK LA / SYR

Administered by: Pharmacy      Purchased by: ??
Symptoms: Injection site erythema, Injection site induration, Injection site pain, Injection site swelling

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: no
Current Illness: none
Preexisting Conditions: no
Allergies: no
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: red hard sore bump two inches in diameter around the injection site

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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1376031&WAYBACKHISTORY=ON

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