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This is VAERS ID 1446299

History of Changes from the VAERS Wayback Machine

First Appeared on 7/9/2021

VAERS ID: 1446299
VAERS Form:2
Age:63.0
Sex:Female
Location:New Jersey
Vaccinated:2021-06-15
Onset:2021-06-29
Submitted:0000-00-00
Entered:2021-07-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 054C21A / 1 LA / SYR

Administered by: Unknown      Purchased by: ??
Symptoms: Rash papular, Rash pruritic, Throat irritation, Urticaria

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: None
Current Illness: Eczema
Preexisting Conditions: Eczema
Allergies: Iodine, penicillin
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: Itchy raised hives, rash started on right hand and arm, hives on both inner thighs,extremely itchy, then also started on left hand and arm, scratchy throat . Treated with Benedry every 4 hrs., hydrocortisone cream 2.5 percent

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