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This is VAERS ID 1398804

History of Changes from the VAERS Wayback Machine

First Appeared on 6/18/2021

VAERS ID: 1398804
VAERS Form:2
Age:49.0
Sex:Female
Location:Arkansas
Vaccinated:2021-06-03
Onset:2021-06-03
Submitted:0000-00-00
Entered:2021-06-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 002621A / 1 - / -

Administered by: Pharmacy      Purchased by: ??
Symptoms: Hypoaesthesia, Injection site rash, Pain in extremity, Pruritus, Rash macular, Pharyngeal 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: zoloft 150mg hydrocodine 10 3 25 mg ropinirole 1mg
Current Illness:
Preexisting Conditions: asthma
Allergies: cherries naproxen ibprofen welbutrin chantix penicillin bactrum
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: 1 hour after vax pain in left arm started along with inching and "dots" broke out around injection site all the way to the elbow, hand feels like its asleep all the time, throat feels swollen

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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1398804&WAYBACKHISTORY=ON


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