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This is VAERS ID 907528

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History of Changes from the VAERS Wayback Machine

First Appeared on 12/30/2020

VAERS ID: 907528
VAERS Form:2
Age:51.0
Sex:Female
Location:Pennsylvania
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 UN / IM

Administered by: Work      Purchased by: ??
Symptoms: Chest X-ray, Full blood count, Pruritus, Troponin I, Metabolic function test

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:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: IV dye, codiene
Diagnostic Lab Data: CBC, CMP, Troponin I, chest xray
CDC 'Split Type':

Write-up: History to allergic to IVP dye, after the covid vaccine and said felt itchy in face. Patient given dexamethasone 10 mg diphenhydramine 50mg ,epinephrine 0.5 mg and lactated ringers. Patient issue resolved and will be discharged home.


Changed on 5/7/2021

VAERS ID: 907528 Before After
VAERS Form:2
Age:51.0
Sex:Female
Location:Pennsylvania
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 UN / IM

Administered by: Work      Purchased by: ??
Symptoms: Chest X-ray, Full blood count, Pruritus, Troponin I, Metabolic function test

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:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: IV dye, codiene codiene
Diagnostic Lab Data: CBC, CMP, Troponin I, chest xray
CDC 'Split Type':

Write-up: History to allergic to IVP dye, after the covid vaccine and said felt itchy in face. Patient given dexamethasone 10 mg diphenhydramine 50mg ,epinephrine 0.5 mg and lactated ringers. Patient issue resolved and will be discharged home.


Changed on 5/14/2021

VAERS ID: 907528 Before After
VAERS Form:2
Age:51.0
Sex:Female
Location:Pennsylvania
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 UN / IM

Administered by: Work      Purchased by: ??
Symptoms: Chest X-ray, Full blood count, Pruritus, Troponin I, Metabolic function test

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:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: IV dye, codiene codiene
Diagnostic Lab Data: CBC, CMP, Troponin I, chest xray
CDC 'Split Type':

Write-up: History to allergic to IVP dye, after the covid vaccine and said felt itchy in face. Patient given dexamethasone 10 mg diphenhydramine 50mg ,epinephrine 0.5 mg and lactated ringers. Patient issue resolved and will be discharged home.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=907528&WAYBACKHISTORY=ON


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