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This is VAERS ID 908637

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History of Changes from the VAERS Wayback Machine

First Appeared on 1/7/2021

VAERS ID: 908637
VAERS Form:2
Age:54.0
Sex:Female
Location:Michigan
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: Sensation of foreign body

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: Chantix Symbicort
Current Illness: None
Preexisting Conditions: Asthma
Allergies: Sulfa Drugs
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: Feels like lump in back of throat, given Epi at clinic without resolution. No shortness of breath or pain


Changed on 5/7/2021

VAERS ID: 908637 Before After
VAERS Form:2
Age:54.0
Sex:Female
Location:Michigan
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: Sensation of foreign body

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: Chantix Symbicort
Current Illness: None
Preexisting Conditions: Asthma
Allergies: Sulfa Drugs Drugs
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: Feels like lump in back of throat, given Epi at clinic without resolution. No shortness of breath or pain


Changed on 5/14/2021

VAERS ID: 908637 Before After
VAERS Form:2
Age:54.0
Sex:Female
Location:Michigan
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: Sensation of foreign body

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: Chantix Symbicort
Current Illness: None
Preexisting Conditions: Asthma
Allergies: Sulfa Drugs Drugs
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: Feels like lump in back of throat, given Epi at clinic without resolution. No shortness of breath or pain

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