National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 906812

History of Changes from the VAERS Wayback Machine

First Appeared on 12/30/2020

VAERS ID: 906812
VAERS Form:2
Age:36.0
Sex:Female
Location:Nebraska
Vaccinated:2020-12-22
Onset:2020-12-22
Submitted:0000-00-00
Entered:2020-12-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011J20A / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Blood glucose, Dizziness, Electrocardiogram, Flushing, Presyncope

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)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Lexapro 20 mg, Vitamin D
Current Illness: None reported
Preexisting Conditions: None reported
Allergies: PCN, Sulfa Antibiotics
Diagnostic Lab Data: EKG, blood glucose
CDC 'Split Type':

Write-up: Dizziness, Flushed, Light headed, Near Syncopal Episode.


Changed on 5/7/2021

VAERS ID: 906812 Before After
VAERS Form:2
Age:36.0
Sex:Female
Location:Nebraska
Vaccinated:2020-12-22
Onset:2020-12-22
Submitted:0000-00-00
Entered:2020-12-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011J20A / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Blood glucose, Dizziness, Electrocardiogram, Flushing, Presyncope

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)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Lexapro 20 mg, Vitamin D
Current Illness: None reported
Preexisting Conditions: None reported
Allergies: PCN, Sulfa Antibiotics Antibiotics
Diagnostic Lab Data: EKG, blood glucose
CDC 'Split Type':

Write-up: Dizziness, Flushed, Light headed, Near Syncopal Episode.


Changed on 5/14/2021

VAERS ID: 906812 Before After
VAERS Form:2
Age:36.0
Sex:Female
Location:Nebraska
Vaccinated:2020-12-22
Onset:2020-12-22
Submitted:0000-00-00
Entered:2020-12-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011J20A / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Blood glucose, Dizziness, Electrocardiogram, Flushing, Presyncope

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)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Lexapro 20 mg, Vitamin D
Current Illness: None reported
Preexisting Conditions: None reported
Allergies: PCN, Sulfa Antibiotics Antibiotics
Diagnostic Lab Data: EKG, blood glucose
CDC 'Split Type':

Write-up: Dizziness, Flushed, Light headed, Near Syncopal Episode.

New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=906812&WAYBACKHISTORY=ON


Copyright © 2021 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166