National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

From the 11/26/2021 release of VAERS data:

This is VAERS ID 1735612

Government Disclaimer on use of this data



Case Details

VAERS ID: 1735612 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-09-23
Onset:2021-09-25
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 088021A / 3 LA / IM

Administered by: School       Purchased by: ?
Symptoms: Extra dose administered, Pain of skin, Photosensitivity reaction, Rash macular
SMQs:, Systemic lupus erythematosus (broad), Hypersensitivity (narrow), Medication errors (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Flonase, xyzal
Current Illness: none
Preexisting Conditions: Seasonal allergies, Diverticuliti
Allergies: Latex
Diagnostic Lab Data: None - just moved out of the sun- wasn''t too worried. This does not happen on my current meds so I thought it was unusual and attributed it to the booster shot.
CDC Split Type:

Write-up: Sun reaction- really blotchy- tender- skin- I immediately moved to the shade. The reaction lasted about three hours- I have pictures on my phone.


New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1735612


Copyright © 2021 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166