National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 1389227

History of Changes from the VAERS Wayback Machine

First Appeared on 6/11/2021

VAERS ID: 1389227
VAERS Form:2
Age:35.0
Sex:Female
Location:Georgia
Vaccinated:2021-05-28
Onset:2021-06-04
Submitted:0000-00-00
Entered:2021-06-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 048B21A / 1 LA / SYR

Administered by: Pharmacy      Purchased by: ??
Symptoms: Blister, Diarrhoea, Rash, Rash maculo-papular, 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: Sertraline 50mg, gemmily (OCP), B12 lozenge, probiotics
Current Illness: None
Preexisting Conditions: Neurocardiogenic syncope
Allergies: NKA
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Approximately 6 days after, I developed a rash on my thighs, hands, forearms, elbows, upper arms, low back, and some on my lower interior stomach. The rash ranged from welt/hive-like to macule/papule type. The ones on my hands felt more like blisters. I had no anaphylaxis... Mild loose stool. Breathing fine. I still have the rash on my hands, elbows, and upper thighs, but it has started to go down as of today.

New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1389227&WAYBACKHISTORY=ON


Copyright © 2021 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166