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This is VAERS ID 1440538

History of Changes from the VAERS Wayback Machine

First Appeared on 7/2/2021

VAERS ID: 1440538
VAERS Form:2
Age:23.0
Sex:Female
Location:Utah
Vaccinated:2021-06-28
Onset:2021-07-01
Submitted:0000-00-00
Entered:2021-07-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 001C21A / UNK RA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Burning sensation, Erythema, Feeling abnormal, Sensory disturbance, Skin wrinkling

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: Pt reported via phone to be experiencing a burning sensation in the neck and face, redness skin appearance that covers a significant portion of her body, something she described as "weird" and unable to explain that''s happening to her elbows, and strange "wrinkles" on her body. Pt said she did not have a PCP, she was instructed to go to her nearest walk in clinic.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1440538&WAYBACKHISTORY=ON


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