National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 907259

Government Disclaimer on use of this data

History of Changes from the VAERS Wayback Machine

First Appeared on 12/30/2020

VAERS ID: 907259
VAERS Form:2
Age:57.0
Sex:Female
Location:Ohio
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 025J20A / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Pruritus, Skin irritation

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)? Yes
Hospitalized? No
Previous Vaccinations: Influenza
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: flu vaccine gets itching
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Severe itching, irritation, took oral Benadryl, proceeded to nearest Emergency Room


Changed on 5/7/2021

VAERS ID: 907259 Before After
VAERS Form:2
Age:57.0
Sex:Female
Location:Ohio
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 025J20A / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Pruritus, Skin irritation

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)? Yes
Hospitalized? No
Previous Vaccinations: Influenza
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: flu vaccine gets itching itching
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Severe itching, irritation, took oral Benadryl, proceeded to nearest Emergency Room


Changed on 5/14/2021

VAERS ID: 907259 Before After
VAERS Form:2
Age:57.0
Sex:Female
Location:Ohio
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 025J20A / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Pruritus, Skin irritation

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)? Yes
Hospitalized? No
Previous Vaccinations: Influenza
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: flu vaccine gets itching itching
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Severe itching, irritation, took oral Benadryl, proceeded to nearest Emergency Room

New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=907259&WAYBACKHISTORY=ON


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