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This is VAERS ID 1745075

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History of Changes from the VAERS Wayback Machine

First Appeared on 10/1/2021

VAERS ID: 1745075
VAERS Form:2
Age:55.0
Sex:Female
Location:Nevada
Vaccinated:2021-09-28
Onset:2021-09-29
Submitted:0000-00-00
Entered:2021-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 045C21A / 1 - / SYR

Administered by: Public      Purchased by: ??
Symptoms: Blood glucose increased, Blood pressure increased, Pain in extremity, Stress, Swollen tongue

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? Yes
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: amLODIPine (NORVASC) 10 mg tablet atorvastatin (LIPITOR) 10 mg tablet baclofen (GABLOFEN) 10 mg tablet butalbital-acetaminophen-caffeine (FIORICET) 50-325-40 mg per tablet clopidogreL (PLAVIX) 75 mg tablet ERGOCALCIFEROL, VITAMIN D2, (
Current Illness:
Preexisting Conditions: Nervous; Carpal tunnel syndrome Cerebrovascular accident (CVA) due to thrombosis of cerebral artery Chronic pain of right knee Left shoulder pain Stroke (From Hx)Circulatory; Diabetes mellitus with coincident hypertension; Hypertension; Hypertension, uncontrolled Digestive; Class 3 severe obesity in adult; Fatty liver; Endocrine/Metabolism; High cholesterol; Hyperlipidemia (Resolved); 12/21/2017; Pure hypercholesterolemia (Resolved); 06/29/2020; Type 2 diabetes mellitus with hyperlipidemia Immune Allergic Drug-induced lupus erythematosus (Resolved) 01/17/2019 Other Abnormal LFTs Abnormal serum protein test
Allergies: Penicillin G Rash Aspirin
Diagnostic Lab Data: none
CDC 'Split Type':

Write-up: tongue swelling, arm pain, elevated blood sugar, elevated blood pressure, stress about vaccine

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