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This is VAERS ID 905986

History of Changes from the VAERS Wayback Machine

First Appeared on 12/30/2020

VAERS ID: 905986
VAERS Form:2
Age:59.0
Sex:Female
Location:Texas
Vaccinated:2020-12-15
Onset:2020-12-17
Submitted:0000-00-00
Entered:2020-12-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA EK 5730 / 1 LA / IM

Administered by: Military      Purchased by: ??
Symptoms: Mass, Pruritus, Skin warm, Swelling, Induration

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: to many to list
Current Illness: none
Preexisting Conditions: b/p, diabetic, on a daily baby asa, chol meds, multi vitamins
Allergies: entex, pcn, adhesive tape sensitivity
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Severe swelling, hard lump, hot to touch, severe itching


Changed on 5/7/2021

VAERS ID: 905986 Before After
VAERS Form:2
Age:59.0
Sex:Female
Location:Texas
Vaccinated:2020-12-15
Onset:2020-12-17
Submitted:0000-00-00
Entered:2020-12-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA EK 5730 / 1 LA / IM

Administered by: Military      Purchased by: ??
Symptoms: Mass, Pruritus, Skin warm, Swelling, Induration

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: to many to list
Current Illness: none
Preexisting Conditions: b/p, diabetic, on a daily baby asa, chol meds, multi vitamins
Allergies: entex, pcn, adhesive tape sensitivity sensitivity
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Severe swelling, hard lump, hot to touch, severe itching


Changed on 5/14/2021

VAERS ID: 905986 Before After
VAERS Form:2
Age:59.0
Sex:Female
Location:Texas
Vaccinated:2020-12-15
Onset:2020-12-17
Submitted:0000-00-00
Entered:2020-12-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA EK 5730 / 1 LA / IM

Administered by: Military      Purchased by: ??
Symptoms: Mass, Pruritus, Skin warm, Swelling, Induration

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: to many to list
Current Illness: none
Preexisting Conditions: b/p, diabetic, on a daily baby asa, chol meds, multi vitamins
Allergies: entex, pcn, adhesive tape sensitivity sensitivity
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Severe swelling, hard lump, hot to touch, severe itching

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