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This is VAERS ID 1382041

History of Changes from the VAERS Wayback Machine

First Appeared on 6/11/2021

VAERS ID: 1382041
VAERS Form:2
Age:38.0
Sex:Male
Location:Ohio
Vaccinated:2021-06-03
Onset:2021-06-04
Submitted:0000-00-00
Entered:2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 036C21A / 2 RA / IM

Administered by: Work      Purchased by: ??
Symptoms: Chills, Erythema, Fatigue, Hypoaesthesia, Pain, Paraesthesia, Pruritus, Pyrexia, Skin warm, Tenderness

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: none
Current Illness: cold a few weeks before vaccine
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: none
CDC 'Split Type':

Write-up: Chills, fatigue. fever(100.9), bodyaches. Redness, warmth, tenderness, itching, tingling and numbness in right arm and fingers.

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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1382041&WAYBACKHISTORY=ON


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