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This is VAERS ID 1475442

History of Changes from the VAERS Wayback Machine

First Appeared on 7/16/2021

VAERS ID: 1475442
VAERS Form:2
Age:42.0
Sex:Female
Location:Missouri
Vaccinated:2021-07-15
Onset:2021-07-15
Submitted:0000-00-00
Entered:2021-07-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 078C21A / 1 LA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Abdominal discomfort, Chest discomfort, Dyspnoea, Feeling hot, Pruritus, Visual impairment

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)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Unknown
Preexisting Conditions: Asthma
Allergies: NKDA
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Within 1-2 minutes of receiving the vaccine, patient stated feeling hot with stomach discomfort, itchiness, heavy sensation on the chest causing a difficulty in breathing, and seeing stars.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1475442&WAYBACKHISTORY=ON


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