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This is VAERS ID 1757900

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History of Changes from the VAERS Wayback Machine

First Appeared on 10/8/2021

VAERS ID: 1757900
VAERS Form:2
Age:37.0
Sex:Female
Location:Kentucky
Vaccinated:2021-10-02
Onset:2021-10-03
Submitted:0000-00-00
Entered:2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 RA / -

Administered by: Pharmacy      Purchased by: ??
Symptoms: Injection site erythema, Injection site mass, Injection site pain, Injection site pruritus, Injection site warmth

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:
Other Medications: Latuda
Current Illness: Active covid infection from 9/06 to 9/22
Preexisting Conditions: Bipolar Unspecified autoimmune disease causing urticaria
Allergies: Eurythamyacin
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Severe lump, redness and itching at injection site. Hot to the touch and extremely sore. No other side effects. Tylenol for arm pain.

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