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This is VAERS ID 1776514

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History of Changes from the VAERS Wayback Machine

First Appeared on 10/15/2021

VAERS ID: 1776514
VAERS Form:2
Age:30.0
Sex:Male
Location:South Carolina
Vaccinated:2021-10-08
Onset:2021-10-10
Submitted:0000-00-00
Entered:2021-10-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / SYR

Administered by: Pharmacy      Purchased by: ??
Symptoms: Eye irritation, Fatigue, Nasal dryness, Throat irritation, Cardiac discomfort

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:
Current Illness: Hypertension Major depressive disorder Bipolar disorder
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Irritated eyes Itchy throat Dry nose Fatigue Heart felt like it was going to burst at times.

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