Your Health. Your Family. Your Choice.
|History of Changes from the VAERS Wayback Machine|
|Vaccination / Manufacturer||Lot / Dose||Site / Route|
|COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA||038C21A / 2||LA / IM|
Administered by: Other Purchased by: ??
Life Threatening? No
Birth Defect? No
Permanent Disability? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Current Illness: Ill and weak for at least a month that pushed off 2nd dose
Preexisting Conditions: Immunocompromised
Allergies: Patient and son verified that patient had no allergies, nor any history of allergic reactions or anaphylaxis
Diagnostic Lab Data:
CDC 'Split Type':
Write-up: Vaccine administration was uneventful. Patient and son confirmed that patient was cleared for vaccine and that she was well during and after the observation period. No signs of distress and no abnormality of breathing.
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