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|History of Changes from the VAERS Wayback Machine|
|Vaccination / Manufacturer||Lot / Dose||Site / Route|
|COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA||049C21A / 1||LA / IM|
Administered by: Pharmacy Purchased by: ??
Symptoms: Anaphylactic reaction, Confusional state, Dizziness, Erythema, Pruritus, Rash pruritic
Life Threatening? No
Birth Defect? No
Permanent Disability? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Diagnostic Lab Data:
CDC 'Split Type':
Write-up: Systemic: Allergic: Anaphylaxis-Medium, Systemic: Allergic: Itch (specify: facial area, extremeties)-Mild, Systemic: Allergic: Rash (specify: facial area, extremeties)-Mild, Systemic: Confusion-Medium, Systemic: Dizziness / Lightheadness-Medium, Additional Details: Patient noticed redness and itching on chest approximately 20 minutes after injection but no other reported symptoms. Patient had already had a hive like rash on arm prior to injection. Patient was advised to stay in store for further observation. After an hour of observation patient denied any further new symptoms and departed. She was advised to stay near town and to call 911 if she developed any other symptoms. Patient called 911 approximately 2 hours after departure and was taken to ER.
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