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This is VAERS ID 1487506

History of Changes from the VAERS Wayback Machine

First Appeared on 7/23/2021

VAERS ID: 1487506
VAERS Form:2
Age:40.0
Sex:Female
Location:North Carolina
Vaccinated:2021-07-10
Onset:2021-07-18
Submitted:0000-00-00
Entered:2021-07-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011021A / 1 LA / SYR

Administered by: Pharmacy      Purchased by: ??
Symptoms: Pruritus, Rash, Swelling

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: Tetanus injection and boosters - last received Jan 2012- local swelling and fever/malaise
Other Medications: Gabapentin Alleve Antihistamine CBD Acidophilus Vitamin d
Current Illness:
Preexisting Conditions: Rosacea Nerve pain from pars defect - 1 year
Allergies: Sulfa drugs- cechlor, Sentra Penicillin Gluten sensitivity
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Itchy bump similar to mosquito bite appeared during evening walk on 07/18. Visible but not itchy rash appeared 4pm 07/20 (1 by 2 inches).

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1487506&WAYBACKHISTORY=ON


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