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This is VAERS ID 1437228

History of Changes from the VAERS Wayback Machine

First Appeared on 7/2/2021

VAERS ID: 1437228
VAERS Form:2
Age:42.0
Sex:Female
Location:Texas
Vaccinated:2021-06-23
Onset:2021-06-29
Submitted:0000-00-00
Entered:2021-06-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 049C21A / 1 LA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Injection site erythema, Injection site pain, Rash, Injection site swelling

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

Write-up: Site: Pain at Injection Site-Medium, Site: Redness at Injection Site-Medium, Site: Swelling at Injection Site-Medium, Additional Details: PATIENT SAYS RASH IS TRAVELING UP ARM AND IS NOW AT NECK. WILL UPDATE US IF GETS WORSE

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1437228&WAYBACKHISTORY=ON


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