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This is VAERS ID 907302

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History of Changes from the VAERS Wayback Machine

First Appeared on 12/30/2020

VAERS ID: 907302
VAERS Form:2
Age:43.0
Sex:Male
Location:New York
Vaccinated:2020-12-21
Onset:2020-12-22
Submitted:0000-00-00
Entered:2020-12-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011J20A / 1 LA / IM

Administered by: Work      Purchased by: ??
Symptoms: Chills, Chromaturia, Eye swelling, Fatigue, Headache, Myalgia, Nausea, Pain, Pyrexia, Rash

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: vit B,b12, finasteride, vascepa, Pepcid, Tylenol, naproxen, Benadryl, and androgel, MGUS ( autoimmune disorder)
Current Illness: none
Preexisting Conditions: low testosterone, high triglucerides
Allergies: none
Diagnostic Lab Data: none
CDC 'Split Type': vsafe

Write-up: 12/23@9:35am EST- Caller stated on12/22/20 at midnight he felt fever 103.0, chills, muscle soreness and aching, nausea and extreme fatigue. Caller called Primary and was told to take Tylenol 1gr. Benadryl and naproxen for headache and body aches. Rash covered arms , neck and thighs and patika on elbow and armpit. This morning rash is still prominent, eyes are swollen and urine is bright red. Caller is awaiting primary to call back.


Changed on 5/7/2021

VAERS ID: 907302 Before After
VAERS Form:2
Age:43.0
Sex:Male
Location:New York
Vaccinated:2020-12-21
Onset:2020-12-22
Submitted:0000-00-00
Entered:2020-12-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011J20A / 1 LA / IM

Administered by: Work      Purchased by: ??
Symptoms: Chills, Chromaturia, Eye swelling, Fatigue, Headache, Myalgia, Nausea, Pain, Pyrexia, Rash

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: vit B,b12, finasteride, vascepa, Pepcid, Tylenol, naproxen, Benadryl, and androgel, MGUS ( autoimmune disorder)
Current Illness: none
Preexisting Conditions: low testosterone, high triglucerides
Allergies: none none
Diagnostic Lab Data: none
CDC 'Split Type': vsafe

Write-up: 12/23@9:35am EST- Caller stated on12/22/20 at midnight he felt fever 103.0, chills, muscle soreness and aching, nausea and extreme fatigue. Caller called Primary and was told to take Tylenol 1gr. Benadryl and naproxen for headache and body aches. Rash covered arms , neck and thighs and patika on elbow and armpit. This morning rash is still prominent, eyes are swollen and urine is bright red. Caller is awaiting primary to call back.


Changed on 5/14/2021

VAERS ID: 907302 Before After
VAERS Form:2
Age:43.0
Sex:Male
Location:New York
Vaccinated:2020-12-21
Onset:2020-12-22
Submitted:0000-00-00
Entered:2020-12-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011J20A / 1 LA / IM

Administered by: Work      Purchased by: ??
Symptoms: Chills, Chromaturia, Eye swelling, Fatigue, Headache, Myalgia, Nausea, Pain, Pyrexia, Rash

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: vit B,b12, finasteride, vascepa, Pepcid, Tylenol, naproxen, Benadryl, and androgel, MGUS ( autoimmune disorder)
Current Illness: none
Preexisting Conditions: low testosterone, high triglucerides
Allergies: none none
Diagnostic Lab Data: none
CDC 'Split Type': vsafe

Write-up: 12/23@9:35am EST- Caller stated on12/22/20 at midnight he felt fever 103.0, chills, muscle soreness and aching, nausea and extreme fatigue. Caller called Primary and was told to take Tylenol 1gr. Benadryl and naproxen for headache and body aches. Rash covered arms , neck and thighs and patika on elbow and armpit. This morning rash is still prominent, eyes are swollen and urine is bright red. Caller is awaiting primary to call back.

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