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This is VAERS ID 1468382

History of Changes from the VAERS Wayback Machine

First Appeared on 7/16/2021

VAERS ID: 1468382
VAERS Form:2
Age:40.0
Sex:Female
Location:California
Vaccinated:2021-07-05
Onset:2021-07-13
Submitted:0000-00-00
Entered:2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

Administered by: Pharmacy      Purchased by: ??
Symptoms: Burning sensation, Injection site induration, Injection site mass, Injection site pain, Pain in extremity, Paraesthesia

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: Vitamens
Current Illness: Staph infection for the first time ever in my life on my face. Had to go to emergency room & given strong antibiotic Rx.
Preexisting Conditions: None.
Allergies: Yes ? allergies to basically everything that grows. Trees, grass, pollen, cats, weeds, certain chemicals, cosmetics & make up products, hygiene items, latex, etc etc. No allergies to any medications that I am aware of.
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: Sore arm with tender big hard ball lump at site of injection. Also tingling & burning in my back shoulder blade area to back of upper arm randomly.

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