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This is VAERS ID 1454356

History of Changes from the VAERS Wayback Machine

First Appeared on 7/9/2021

VAERS ID: 1454356
VAERS Form:2
Age:77.0
Sex:Female
Location:Florida
Vaccinated:2021-07-07
Onset:2021-07-07
Submitted:0000-00-00
Entered:2021-07-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 031B21A / 2 RA / IM

Administered by: Private      Purchased by: ??
Symptoms: Dizziness, Paraesthesia

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

Write-up: 1205p back to clinic c/o "whoozie" and hands tingling, water given, cool cloth to forehead, BP 147/84 P 73 R 18 SpO2 95% RA, 12:16p pt reports "better" denies any s/s, BP 135/78 P69 R 18 SpO2 96% RA, ambulated with RN to valet parking

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1454356&WAYBACKHISTORY=ON


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