National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 1430113

History of Changes from the VAERS Wayback Machine

First Appeared on 7/2/2021

VAERS ID: 1430113
VAERS Form:2
Age:28.0
Sex:Male
Location:California
Vaccinated:2021-06-26
Onset:2021-06-26
Submitted:0000-00-00
Entered:2021-06-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011D21A / 1 LA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Feeling hot, Flushing, Hyperhidrosis, Injection site pain, Vision blurred

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)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Site: Pain at Injection Site-Mild, Systemic: PT SAID HE IS VERY WARM AFTER INJECTION AND STARTED SWEATING. THEN HE SAID THINS ARE VERY BLURRY AND WE CALLED 911. THEY CAME AND CHECKED ON HIM AND THEN TOOK HIM WITH THEM.-Severe, Systemic: Flushed / Sweating-Severe

New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1430113&WAYBACKHISTORY=ON


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