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This is VAERS ID 1431063

History of Changes from the VAERS Wayback Machine

First Appeared on 7/2/2021

VAERS ID: 1431063
VAERS Form:2
Age:35.0
Sex:Female
Location:West Virginia
Vaccinated:2021-06-17
Onset:2021-06-26
Submitted:0000-00-00
Entered:2021-06-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 041C21A / 1 RA / IM

Administered by: Senior Living      Purchased by: ??
Symptoms: Injection site erythema, Injection site pruritus, Urticaria

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: Wellbutrin XL 150mg, ProAir HFA, Claritin 10mg, Levothyroxine 50mcg
Current Illness: none
Preexisting Conditions: Hypothyroidism, Depression, Asthma
Allergies: none
Diagnostic Lab Data: none
CDC 'Split Type':

Write-up: Red welt on right arm injection site that itched. No treatment was given, event subsided

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1431063&WAYBACKHISTORY=ON


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