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This is VAERS ID 1775640

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History of Changes from the VAERS Wayback Machine

First Appeared on 10/15/2021

VAERS ID: 1775640
VAERS Form:2
Age:34.0
Sex:Female
Location:North Carolina
Vaccinated:2021-09-26
Onset:2021-10-01
Submitted:0000-00-00
Entered:2021-10-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939901 / 1 LA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Ageusia, Anosmia, Feeling abnormal, Headache

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: Birth Control
Current Illness: None
Preexisting Conditions: PCOS
Allergies: None
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Loss of taste and smell for two weeks, "brain fog", persistent headache

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