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This is VAERS ID 1467550

History of Changes from the VAERS Wayback Machine

First Appeared on 7/16/2021

VAERS ID: 1467550
VAERS Form:2
Age:20.0
Sex:Male
Location:Wisconsin
Vaccinated:2021-07-13
Onset:2021-07-13
Submitted:0000-00-00
Entered:2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 004D21A / 2 LA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Myalgia, Pain, Axillary pain

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: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: The patient reported to pharmacy around 6:45pm with pain near his pectoral muscle that had begun around 6:30 pm. The pain was mostly in his armpit and was severe enough that he couldn''t lift his arm without pain increasing. His vaccine occurred around 4:20pm and he then returned to work stocking shelves.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1467550&WAYBACKHISTORY=ON

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