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This is VAERS ID 1779911

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History of Changes from the VAERS Wayback Machine

First Appeared on 10/15/2021

VAERS ID: 1779911
VAERS Form:2
Age:47.0
Sex:Female
Location:Puerto Rico
Vaccinated:2021-10-09
Onset:2021-10-09
Submitted:0000-00-00
Entered:2021-10-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 039D21A / 3 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Cellulitis, Condition aggravated, Diarrhoea, Dyspnoea, Fatigue, Headache, Myalgia, Nausea, Pyrexia

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: Severe Cellulites left arm, fever, muscular pain, head pain, nausea, diarrhea, difficult respiration, cough. 47 year female pati
Other Medications: Cabergoline 5mg, Synthroid 137mg
Current Illness: prolactinoma
Preexisting Conditions: chronic Asthma, COPD
Allergies: No
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Severe Cellulitis on left arm, 40 degree fever for 3 days. Body muscular pain, nausea, diarrhea, head pain, tiredness, difficult respiration. I started with Antibiotics, Levaquin 750mg ever 12 hours, Flovent HFA 110mcg twice per day, Albuterol 90mcg twice per day, Symbicort once per day. Severe Cellulites left arm, fever, muscular pain, head pain, nausea, diarrhea, difficult respiration, cough. 47 year female patient receives MODERNA 3rd dose October 10 2021.

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