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This is VAERS ID 1454781

History of Changes from the VAERS Wayback Machine

First Appeared on 7/9/2021

VAERS ID: 1454781
VAERS Form:2
Age:45.0
Sex:Female
Location:North Carolina
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 041C21A / 1 RA / IM

Administered by: Private      Purchased by: ??
Symptoms: Erythema, Pruritus, Stridor, Pharyngeal swelling

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)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: albuterol, flexeril, Voltaren doxycycline, Lasix, neurotin, atarax, plaquenil, Flonase, allergra, epi pen, Lidocain, Mag oxide, ativerrt, singulair, Minipress, pyridium Phenergan, Zoloft, Verapamil
Current Illness: Obesity, pelvic pain, Gerd, Biliary colic, chronic pain, Rash, anxiety, Chronic diarrhea, vertigo, asthma, Migraines, PTSd,, Depression, IBS, Endometrosis
Preexisting Conditions: same
Allergies: Aspirin, Beef, Motrin, Nsaids, PCN, soy, sulfa, Trazadone, Wheat, Egg Ahesive, Gluten, Latex
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: throat swelling, stridor, redness, itching,

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