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This is VAERS ID 1397488

History of Changes from the VAERS Wayback Machine

First Appeared on 6/18/2021

VAERS ID: 1397488
VAERS Form:2
Age:70.0
Sex:Female
Location:California
Vaccinated:2021-05-05
Onset:2021-06-03
Submitted:0000-00-00
Entered:2021-06-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 047B21A / 2 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Chest discomfort, Herpes zoster, Joint swelling, Muscle spasms, Pain in extremity, Pyrexia, Urticaria, Peripheral swelling, Limb discomfort

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: influenza skin rash and or hives--brand and date unknown
Other Medications: zyrtec 5 mg daily lipitor 20 mg daily norvasc 10 mg daily lisinopril 20 mg calcium carbonate-D3--1500 mg/400 unit
Current Illness: none
Preexisting Conditions: severe obesity BMI 42
Allergies: PCN--rash and or hives influenza vaccination--rash and or hives bee venom
Diagnostic Lab Data: none.
CDC 'Split Type':

Write-up: Patient reports high fever to 101, left arm hurt and swelled and had a "giant hive size of hand print" and muscle cramps and biceps turned hard, wrist swelled to where fit bit had to be removed. Then prodrome of shingles started 6/10 and she broke out in the vesicular shingles rash 6/11. right superior anterior chest.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1397488&WAYBACKHISTORY=ON


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