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This is VAERS ID 1768514

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History of Changes from the VAERS Wayback Machine

First Appeared on 10/8/2021

VAERS ID: 1768514
VAERS Form:2
Age:27.0
Sex:Female
Location:Illinois
Vaccinated:2021-09-27
Onset:2021-10-04
Submitted:0000-00-00
Entered:2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 061E21A / 1 RA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Injection site induration, Injection site pruritus, Injection site warmth, Injection site nodule

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: alprazolam 0.5 mg
Current Illness: none
Preexisting Conditions: none
Allergies: latex , eggs
Diagnostic Lab Data: none
CDC 'Split Type':

Write-up: one week after the shot patient had warmth , itching and a hard knot at the injection site , Dr . called it Covid arm

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