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This is VAERS ID 1764862

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History of Changes from the VAERS Wayback Machine

First Appeared on 10/8/2021

VAERS ID: 1764862
VAERS Form:2
Age:69.0
Sex:Female
Location:West Virginia
Vaccinated:2021-09-30
Onset:2021-09-30
Submitted:0000-00-00
Entered:2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 027C21A / 3 LA / SYR

Administered by: Pharmacy      Purchased by: ??
Symptoms: Lymphoedema

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: COVID-19 Moderna, Second Dose -fever, chills, aches, resolved after one day.
Other Medications: Letrozole, escitalopram, vitamin B complex, folic acid, diclofenac potassium, magnesium and calcium supplement, Centrum Silver one-a-day.
Current Illness: None
Preexisting Conditions: No spleen, hemochromatosis, breast cancer ("cured")
Allergies: None
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Lymphedema under the left arm - worst on day 2, and slowly resolving at day 6.

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