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This is VAERS ID 1389303

History of Changes from the VAERS Wayback Machine

First Appeared on 6/11/2021

VAERS ID: 1389303
VAERS Form:2
Age:35.0
Sex:Female
Location:Colorado
Vaccinated:2021-06-04
Onset:2021-06-04
Submitted:0000-00-00
Entered:2021-06-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 001C21A / 2 RA / IM

Administered by: Private      Purchased by: ??
Symptoms: Cough, Flank pain, Headache, Nausea, Pain, Pyrexia, Vomiting, SARS-CoV-2 test

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: None
Preexisting Conditions: Migraines, depression
Allergies: None
Diagnostic Lab Data: PCR COVID pending, collected on 6/10/2021
CDC 'Split Type':

Write-up: severe headache, body aches, fever (highest 102.3), and flank pain (right) for 7d. As well as, milder nausea/vomiting. Mild cough after 6d of vaccination (#2).

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