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This is VAERS ID 908125

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History of Changes from the VAERS Wayback Machine

First Appeared on 12/30/2020

VAERS ID: 908125
VAERS Form:2
Age:34.0
Sex:Female
Location:California
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 02SJ20-2A / 1 RA / -

Administered by: Private      Purchased by: ??
Symptoms: Blood glucose normal, Electrocardiogram normal, Heart rate increased, Paraesthesia oral

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)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Denies
Current Illness: Denies
Preexisting Conditions: S/P gastric bypass
Allergies: Denies
Diagnostic Lab Data: EKG; normal, rate 81, no arrythmias, normal intervals Glucose 105 500ml NS Bolus Observed and discharged without further issue
CDC 'Split Type':

Write-up: 30 mins after vaccination Felt rapid heart rate, tingling in lips, initial BP 100/60


Changed on 5/7/2021

VAERS ID: 908125 Before After
VAERS Form:2
Age:34.0
Sex:Female
Location:California
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 02SJ20-2A / 1 RA / -

Administered by: Private      Purchased by: ??
Symptoms: Blood glucose normal, Electrocardiogram normal, Heart rate increased, Paraesthesia oral

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)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Denies
Current Illness: Denies
Preexisting Conditions: S/P gastric bypass
Allergies: Denies Denies
Diagnostic Lab Data: EKG; normal, rate 81, no arrythmias, normal intervals Glucose 105 500ml NS Bolus Observed and discharged without further issue
CDC 'Split Type':

Write-up: 30 mins after vaccination Felt rapid heart rate, tingling in lips, initial BP 100/60


Changed on 5/21/2021

VAERS ID: 908125 Before After
VAERS Form:2
Age:34.0
Sex:Female
Location:California
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 02SJ20-2A / 1 RA / -

Administered by: Private      Purchased by: ??
Symptoms: Blood glucose normal, Electrocardiogram normal, Heart rate increased, Paraesthesia oral

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)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Denies
Current Illness: Denies
Preexisting Conditions: S/P gastric bypass
Allergies: Denies Denies
Diagnostic Lab Data: EKG; normal, rate 81, no arrythmias, normal intervals Glucose 105 500ml NS Bolus Observed and discharged without further issue
CDC 'Split Type':

Write-up: 30 mins after vaccination Felt rapid heart rate, tingling in lips, initial BP 100/60

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