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This is VAERS ID 1397867

History of Changes from the VAERS Wayback Machine

First Appeared on 7/23/2021

VAERS ID: 1397867
VAERS Form:2
Age:34.0
Sex:Female
Location:Foreign
Vaccinated:2021-05-28
Onset:2021-06-04
Submitted:0000-00-00
Entered:2021-06-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

Administered by: Unknown      Purchased by: ??
Symptoms: Discomfort, Erythema, Peripheral swelling

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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': GBMODERNATX, INC.MOD20212

Write-up: Swollen arm; Redness; mild discomfort; This regulatory authority case was reported by a consumer and describes the occurrence of PERIPHERAL SWELLING (Swollen arm) and ERYTHEMA (Redness) in a 34-year-old female patient who received mRNA-1273 (Moderna CoviD-19 Vaccine) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 28-May-2021, the patient received first dose of mRNA-1273 (Moderna CoviD-19 Vaccine) (unknown route) 1 dosage form. On 04-Jun-2021, the patient experienced PERIPHERAL SWELLING (Swollen arm) and ERYTHEMA (Redness). 04-Jun-2021, the patient experienced DISCOMFORT (mild discomfort). At the time of the report, PERIPHERAL SWELLING (Swollen arm) and ERYTHEMA (Redness) had not resolved and DISCOMFORT (mild discomfort) outcome was unknown. The action taken with mRNA-1273 (Moderna CoviD-19 Vaccine) (Unknown) was unknown. Patient experienced 7 days after infection, red swollen and hot patch (roughly 20 cm by 6 cm) which was causing mild discomfort. Relevant concomitant medications were not reported. Treatment medication was not provided. Very limited information regarding these events has been provided at this time. No further information is expected.; Sender''s Comments: Very limited information regarding these events has been provided at this time. No further information is expected.

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