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This is VAERS ID 1775057

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History of Changes from the VAERS Wayback Machine

First Appeared on 10/15/2021

VAERS ID: 1775057
VAERS Form:2
Age:32.0
Sex:Female
Location:Florida
Vaccinated:2021-09-29
Onset:2021-10-09
Submitted:0000-00-00
Entered:2021-10-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Eye irritation, Lip swelling, Oral discomfort, Paraesthesia, Swelling face, Throat irritation, Paraesthesia oral

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: Adderall Birth Control
Current Illness: None
Preexisting Conditions: ADHD, Kinsey Stones
Allergies: None
Diagnostic Lab Data: Benadryl
CDC 'Split Type':

Write-up: Swelling of lips and face. Tingling and burning of eyes, face, lips and throat.

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