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This is VAERS ID 1447138

History of Changes from the VAERS Wayback Machine

First Appeared on 7/9/2021

VAERS ID: 1447138
VAERS Form:2
Age:63.0
Sex:Male
Location:Oregon
Vaccinated:2021-06-22
Onset:2021-06-25
Submitted:0000-00-00
Entered:2021-07-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 016B21A / 2 LA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Aphthous ulcer, Oral pain, Oral disorder

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: unknown. Only service we have given this pt is covid vaccine #1 & #2
Current Illness: none
Preexisting Conditions: none
Allergies: Penicillins, codeine
Diagnostic Lab Data: none
CDC 'Split Type':

Write-up: Started developing canker sores and raw spots on oral mucosa, tongue and gums approximately three days after injection, peaking in severity 7/3/2021. Started improving yesterday and nearly cleared up by today. **In retrospect, patient recalls having a sore mouth with no visual lesions after first dose for a few days**

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1447138&WAYBACKHISTORY=ON


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