National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 907481

Government Disclaimer on use of this data

History of Changes from the VAERS Wayback Machine

First Appeared on 12/30/2020

VAERS ID: 907481
VAERS Form:2
Age:29.0
Sex:Female
Location:New York
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 LA / IM

Administered by: Work      Purchased by: ??
Symptoms: Cold sweat, Flushing

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: n/a
Current Illness: N/a
Preexisting Conditions: Congenital adrenal hyperplasia
Allergies: N/a
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Became flush and clammy 2-3 times. Recovered after 30 minutes of observation


Changed on 5/7/2021

VAERS ID: 907481 Before After
VAERS Form:2
Age:29.0
Sex:Female
Location:New York
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 LA / IM

Administered by: Work      Purchased by: ??
Symptoms: Cold sweat, Flushing

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: n/a
Current Illness: N/a
Preexisting Conditions: Congenital adrenal hyperplasia
Allergies: N/a N/a
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Became flush and clammy 2-3 times. Recovered after 30 minutes of observation


Changed on 5/14/2021

VAERS ID: 907481 Before After
VAERS Form:2
Age:29.0
Sex:Female
Location:New York
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 LA / IM

Administered by: Work      Purchased by: ??
Symptoms: Cold sweat, Flushing

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: n/a
Current Illness: N/a
Preexisting Conditions: Congenital adrenal hyperplasia
Allergies: N/a N/a
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Became flush and clammy 2-3 times. Recovered after 30 minutes of observation

New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=907481&WAYBACKHISTORY=ON


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