National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts.org
Search Results

This is VAERS ID 1779068

Government Disclaimer on use of this data

History of Changes from the VAERS Wayback Machine

First Appeared on 10/15/2021

VAERS ID: 1779068
VAERS Form:2
Age:60.0
Sex:Female
Location:Michigan
Vaccinated:2021-10-01
Onset:2021-10-01
Submitted:0000-00-00
Entered:2021-10-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 033C21A / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Injection site pruritus, Swelling

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: Morphine sulfate ER,Famotidine, Verapamil ER, Lamictal XR, Trokendi XR, Levetiracetam ER, Vitamin D, Calcium/vitamin D
Current Illness: None
Preexisting Conditions: Ehlers-danlos syndrome, Sjogren''s syndrome, Hashimoto''s, Chronic pain
Allergies: Keflax, tofranil
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: Slight swelling, deep down itching at injection site. Still there on Oct 11

New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1779068&WAYBACKHISTORY=ON


Copyright © 2022 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166