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This is VAERS ID 908537

History of Changes from the VAERS Wayback Machine

First Appeared on 1/7/2021

VAERS ID: 908537
VAERS Form:2
Age:34.0
Sex:Female
Location:Washington
Vaccinated:2020-12-23
Onset:2020-12-23
Submitted:0000-00-00
Entered:2020-12-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037K20A / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Erythema, Flushing, Hypersensitivity, Lacrimation increased, Rhinorrhoea

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: N/A
Allergies: None
Diagnostic Lab Data: N/A
CDC 'Split Type':

Write-up: Hypersensitivity reaction. Redness, flushing, runny nose, watery eyes. Gave Diphenhydramine 25mg PO. Symptoms subsided after about 20 minutes. Patient stayed in the clinic for observation for approximately 1 hour. Advised to call 911 and seek emergency medical care if any symptoms started again after leaving the clinic. Patient expressed understanding.


Changed on 5/7/2021

VAERS ID: 908537 Before After
VAERS Form:2
Age:34.0
Sex:Female
Location:Washington
Vaccinated:2020-12-23
Onset:2020-12-23
Submitted:0000-00-00
Entered:2020-12-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037K20A / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Erythema, Flushing, Hypersensitivity, Lacrimation increased, Rhinorrhoea

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: N/A
Allergies: None None
Diagnostic Lab Data: N/A
CDC 'Split Type':

Write-up: Hypersensitivity reaction. Redness, flushing, runny nose, watery eyes. Gave Diphenhydramine 25mg PO. Symptoms subsided after about 20 minutes. Patient stayed in the clinic for observation for approximately 1 hour. Advised to call 911 and seek emergency medical care if any symptoms started again after leaving the clinic. Patient expressed understanding.


Changed on 5/14/2021

VAERS ID: 908537 Before After
VAERS Form:2
Age:34.0
Sex:Female
Location:Washington
Vaccinated:2020-12-23
Onset:2020-12-23
Submitted:0000-00-00
Entered:2020-12-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037K20A / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Erythema, Flushing, Hypersensitivity, Lacrimation increased, Rhinorrhoea

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: N/A
Allergies: None None
Diagnostic Lab Data: N/A
CDC 'Split Type':

Write-up: Hypersensitivity reaction. Redness, flushing, runny nose, watery eyes. Gave Diphenhydramine 25mg PO. Symptoms subsided after about 20 minutes. Patient stayed in the clinic for observation for approximately 1 hour. Advised to call 911 and seek emergency medical care if any symptoms started again after leaving the clinic. Patient expressed understanding.

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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=908537&WAYBACKHISTORY=ON

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