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This is VAERS ID 1385215

History of Changes from the VAERS Wayback Machine

First Appeared on 6/11/2021

VAERS ID: 1385215
VAERS Form:2
Age:23.0
Sex:Female
Location:Nebraska
Vaccinated:2021-06-03
Onset:2021-06-04
Submitted:0000-00-00
Entered:2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 036B4A / 1 LA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Lymph node pain, Rash

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? Yes
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin D and Vitamin B12
Current Illness: None
Preexisting Conditions: Congenital CMV Nonfunctional cochlear implant
Allergies: NKMA
Diagnostic Lab Data: None, resolving.
CDC 'Split Type':

Write-up: Approximately 24 hours after getting immunization she had a reticular rash on the entirety of her left thigh and pain in the inguinal lymph nodes. Nearly resolved 24 hours later.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1385215&WAYBACKHISTORY=ON


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