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This is VAERS ID 908540

History of Changes from the VAERS Wayback Machine

First Appeared on 1/7/2021

VAERS ID: 908540
VAERS Form:2
Age:25.0
Sex:Female
Location:Maine
Vaccinated:2020-12-24
Onset:2020-12-24
Submitted:0000-00-00
Entered:2020-12-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 026L20A / 1 RA / IM

Administered by: Private      Purchased by: ??
Symptoms: Lip swelling, Tachycardia, 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)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Ocella
Current Illness:
Preexisting Conditions:
Allergies: Amoxicillin (hives)
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: About 30 minutes after receiving vaccination, patient started to have tingling and mild swelling in her lips as well as tachycardia. Vital signs taken. Heart rate was 102 bpm, respiratory rate 18, blood pressure 144/80, O2 Sat 98%. Received cetirizine 10 mg PO. Symptoms resolved within one hour of receiving cetirizine.


Changed on 5/7/2021

VAERS ID: 908540 Before After
VAERS Form:2
Age:25.0
Sex:Female
Location:Maine
Vaccinated:2020-12-24
Onset:2020-12-24
Submitted:0000-00-00
Entered:2020-12-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 026L20A / 1 RA / IM

Administered by: Private      Purchased by: ??
Symptoms: Lip swelling, Tachycardia, 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)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Ocella
Current Illness:
Preexisting Conditions:
Allergies: Amoxicillin (hives) (hives)
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: About 30 minutes after receiving vaccination, patient started to have tingling and mild swelling in her lips as well as tachycardia. Vital signs taken. Heart rate was 102 bpm, respiratory rate 18, blood pressure 144/80, O2 Sat 98%. Received cetirizine 10 mg PO. Symptoms resolved within one hour of receiving cetirizine.


Changed on 5/14/2021

VAERS ID: 908540 Before After
VAERS Form:2
Age:25.0
Sex:Female
Location:Maine
Vaccinated:2020-12-24
Onset:2020-12-24
Submitted:0000-00-00
Entered:2020-12-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 026L20A / 1 RA / IM

Administered by: Private      Purchased by: ??
Symptoms: Lip swelling, Tachycardia, 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)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Ocella
Current Illness:
Preexisting Conditions:
Allergies: Amoxicillin (hives) (hives)
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: About 30 minutes after receiving vaccination, patient started to have tingling and mild swelling in her lips as well as tachycardia. Vital signs taken. Heart rate was 102 bpm, respiratory rate 18, blood pressure 144/80, O2 Sat 98%. Received cetirizine 10 mg PO. Symptoms resolved within one hour of receiving cetirizine.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=908540&WAYBACKHISTORY=ON

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