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This is VAERS ID 1430518

History of Changes from the VAERS Wayback Machine

First Appeared on 7/2/2021

VAERS ID: 1430518
VAERS Form:2
Age:74.0
Sex:Female
Location:Michigan
Vaccinated:2021-06-23
Onset:2021-06-26
Submitted:0000-00-00
Entered:2021-06-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011D21A / 2 LA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Injection site bruising, Injection site erythema, Injection site pain, Injection site swelling, Immune-mediated adverse reaction

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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Site: Bruising at Injection Site-Mild, Site: Pain at Injection Site-Mild, Site: Redness at Injection Site-Medium, Site: Swelling at Injection Site-Medium, Additional Details: Appeared to be an immune reaction to the shot, but patient was convinced it was cellulitis. She believes that bacteria got into the injection site. The pharmacist who gave her shot to her used an alcohol swab before administering the shot.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1430518&WAYBACKHISTORY=ON


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