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This is VAERS ID 1430305

History of Changes from the VAERS Wayback Machine

First Appeared on 7/2/2021

VAERS ID: 1430305
VAERS Form:2
Age:34.0
Sex:Male
Location:Georgia
Vaccinated:2021-06-25
Onset:2021-06-26
Submitted:0000-00-00
Entered:2021-06-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 026D21A / 2 - / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Lip swelling

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? Yes
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Xanax 2 mg
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient had lips that were swelling one day after event.

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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1430305&WAYBACKHISTORY=ON


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