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This is VAERS ID 1775352

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History of Changes from the VAERS Wayback Machine

First Appeared on 10/15/2021

VAERS ID: 1775352
VAERS Form:2
Age:33.0
Sex:Female
Location:Florida
Vaccinated:2021-10-01
Onset:2021-10-09
Submitted:0000-00-00
Entered:2021-10-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 061E21A / 1 LA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Mass

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: Liposomal Glutathione, Pre-natal, Probiotic
Current Illness: none
Preexisting Conditions: Fibroadenoma of breast
Allergies: Aplisol PPD (mild reaction)
Diagnostic Lab Data: n/a at the moment
CDC 'Split Type':

Write-up: The morning after receiving the first vaccination dose, a small (almost 1 cm) hard, non-tender, immobile lump appeared on the right-outer area of my hard palate. It has been 8 days and the lump is still present; however, it is smaller in size. To be seen by my ENT for follow-up if lump remains persistent after 2 weeks.

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