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This is VAERS ID 1430257

History of Changes from the VAERS Wayback Machine

First Appeared on 7/2/2021

VAERS ID: 1430257
VAERS Form:2
Age:62.0
Sex:Female
Location:Pennsylvania
Vaccinated:2021-06-24
Onset:2021-06-26
Submitted:0000-00-00
Entered:2021-06-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011D21A / 2 LA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Injection site erythema, Injection site reaction, Rash pruritic

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: metformin
Current Illness: none
Preexisting Conditions: diabetes
Allergies: none
Diagnostic Lab Data: n/a
CDC 'Split Type':

Write-up: patient reported getting covid arm. Patient had itchy rash and redness at injection site

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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1430257&WAYBACKHISTORY=ON


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