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This is VAERS ID 1484967

History of Changes from the VAERS Wayback Machine

First Appeared on 7/23/2021

VAERS ID: 1484967
VAERS Form:2
Age:26.0
Sex:Female
Location:Florida
Vaccinated:2021-07-17
Onset:2021-07-18
Submitted:0000-00-00
Entered:2021-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 040C21A / 2 LA / SYR

Administered by: Pharmacy      Purchased by: ??
Symptoms: Abdominal pain, Chills, Myalgia, Nausea, Pain in extremity, Pyrexia, Vomiting

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: Annually, last at age 25, flu vaccine, similar symptoms
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Approx 8 hours after shot, developed fever, chills, myalgias, nausea, vomiting and abdominal pain, severe. Symptoms lasted over 12 hours. By 24 hours, fever and arm soreness persisted.

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