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This is VAERS ID 905142

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History of Changes from the VAERS Wayback Machine

First Appeared on 12/30/2020

VAERS ID: 905142
VAERS Form:2
Age:40.0
Sex:Male
Location:California
Vaccinated:2020-12-18
Onset:2020-12-19
Submitted:0000-00-00
Entered:2020-12-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA EJ1685 / 1 LA / SYR

Administered by: Unknown      Purchased by: ??
Symptoms: Pyrexia

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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Fever


Changed on 5/7/2021

VAERS ID: 905142 Before After
VAERS Form:2
Age:40.0
Sex:Male
Location:California
Vaccinated:2020-12-18
Onset:2020-12-19
Submitted:0000-00-00
Entered:2020-12-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA EJ1685 / 1 LA / SYR

Administered by: Unknown      Purchased by: ??
Symptoms: Pyrexia

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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Fever


Changed on 5/14/2021

VAERS ID: 905142 Before After
VAERS Form:2
Age:40.0
Sex:Male
Location:California
Vaccinated:2020-12-18
Onset:2020-12-19
Submitted:0000-00-00
Entered:2020-12-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA EJ1685 / 1 LA / SYR

Administered by: Unknown      Purchased by: ??
Symptoms: Pyrexia

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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Fever

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=905142&WAYBACKHISTORY=ON


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