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This is VAERS ID 907250

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History of Changes from the VAERS Wayback Machine

First Appeared on 12/30/2020

VAERS ID: 907250
VAERS Form:2
Age:34.0
Sex:Female
Location:West Virginia
Vaccinated:2020-12-23
Onset:2020-12-23
Submitted:0000-00-00
Entered:2020-12-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011J20A / 1 RA / IM

Administered by: Senior Living      Purchased by: ??
Symptoms: Dysphagia, Nausea, Paraesthesia, Vomiting

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: Buspar, Ventolin, Nuvaring, Phenergan
Current Illness: n/a
Preexisting Conditions: Asthma
Allergies: Sulfa Medications
Diagnostic Lab Data: n/a
CDC 'Split Type':

Write-up: Vomiting, Cheeks feel tingling, Slight difficulty swallowing. Rest and will take oral Benadryl when gets home. Will take Phenergan for nausea when gets home as well. Starting to feel better after 2 hours.


Changed on 5/7/2021

VAERS ID: 907250 Before After
VAERS Form:2
Age:34.0
Sex:Female
Location:West Virginia
Vaccinated:2020-12-23
Onset:2020-12-23
Submitted:0000-00-00
Entered:2020-12-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011J20A / 1 RA / IM

Administered by: Senior Living      Purchased by: ??
Symptoms: Dysphagia, Nausea, Paraesthesia, Vomiting

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: Buspar, Ventolin, Nuvaring, Phenergan
Current Illness: n/a
Preexisting Conditions: Asthma
Allergies: Sulfa Medications Medications
Diagnostic Lab Data: n/a
CDC 'Split Type':

Write-up: Vomiting, Cheeks feel tingling, Slight difficulty swallowing. Rest and will take oral Benadryl when gets home. Will take Phenergan for nausea when gets home as well. Starting to feel better after 2 hours.


Changed on 5/14/2021

VAERS ID: 907250 Before After
VAERS Form:2
Age:34.0
Sex:Female
Location:West Virginia
Vaccinated:2020-12-23
Onset:2020-12-23
Submitted:0000-00-00
Entered:2020-12-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011J20A / 1 RA / IM

Administered by: Senior Living      Purchased by: ??
Symptoms: Dysphagia, Nausea, Paraesthesia, Vomiting

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: Buspar, Ventolin, Nuvaring, Phenergan
Current Illness: n/a
Preexisting Conditions: Asthma
Allergies: Sulfa Medications Medications
Diagnostic Lab Data: n/a
CDC 'Split Type':

Write-up: Vomiting, Cheeks feel tingling, Slight difficulty swallowing. Rest and will take oral Benadryl when gets home. Will take Phenergan for nausea when gets home as well. Starting to feel better after 2 hours.

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