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This is VAERS ID 1430280

History of Changes from the VAERS Wayback Machine

First Appeared on 7/2/2021

VAERS ID: 1430280
VAERS Form:2
Age:29.0
Sex:Female
Location:Pennsylvania
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 054C21A / 1 LA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Anxiety, Feeling hot, Paraesthesia

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: Patient describes wide spread tingling and warm sensation in upper body stretching to the face as well as both arms. She reports no fever but is unable to tell if any erythema as she is African American. She said it started late last night and has not changed since that time. She said it felt like she had been out in the sun all day but also the skin was tingling. Since she described tingling skin and warm sensation I had advised her to be checked for possible allergic reaction. Pt was going to go to urgent care to get checked out. Pt did report also suffering from anxiety during telephone call and was not sure it it could have contributed to the situation.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1430280&WAYBACKHISTORY=ON

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