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This is VAERS ID 1437409

History of Changes from the VAERS Wayback Machine

First Appeared on 7/2/2021

VAERS ID: 1437409
VAERS Form:2
Age:58.0
Sex:Male
Location:Georgia
Vaccinated:2021-06-28
Onset:2021-06-30
Submitted:0000-00-00
Entered:2021-06-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 078C21A / 1 LA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Pain in extremity, Axillary mass

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: Tamsulosin 0.8mg daily, Meloxicam 15mg daily as needed, donepezil 5mg at bedtime, Albuterol HFA 1 puff as needed for wheezing, Eliquis 5mg twice daily, Fluticasone Nasal spray 2 sprays each nostril daily, Atorvastatin 40mg daily, Amlodipine
Current Illness:
Preexisting Conditions: Arthritis, Asthma, Chest pain, Depression, Enlarged prostate, High blood pressure, Hypercholesterolemia, Dementia (early stages), Schizophrenia, Seizures, Pain
Allergies: NKDA
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient''s wife called around 10:30a on 06/30/2021 and said he had a knot under his left arm. She stated his arm was sore in addition to knot. It was recommended by pharmacist that he could take acetaminophen for the soreness and apply a cool compress for the swelling. I asked her to call us if anything changes or if she notices any new symptoms. We will follow up with patient in 24 hours to assess how he is doing.

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