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This is VAERS ID 1377691

History of Changes from the VAERS Wayback Machine

First Appeared on 6/11/2021

VAERS ID: 1377691
VAERS Form:2
Age:23.0
Sex:Female
Location:Indiana
Vaccinated:2021-06-03
Onset:2021-06-04
Submitted:0000-00-00
Entered:2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / SYR

Administered by: Private      Purchased by: ??
Symptoms: Erythema, Feeling hot, Tenderness, Urticaria

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: Tri sprintec Montelukast 10mg Prozac 20mg Levothyroxine 50mg Metformin 500mg Clonidine 0.3mg (x2)
Current Illness:
Preexisting Conditions:
Allergies: Sulfa and anything with lavender
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Hives broken out on left arm. Red and very sore to the touch. Radiating heat. Since June 4th to present

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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1377691&WAYBACKHISTORY=ON

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