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This is VAERS ID 908662

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History of Changes from the VAERS Wayback Machine

First Appeared on 12/30/2020

VAERS ID: 908662
VAERS Form:2
Age:51.0
Sex:Female
Location:Arizona
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 011J2OA / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Dysgeusia, Flushing

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)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: pristiq, crestor, lyrica, zyrtec, desmopressin, bystolic
Current Illness: none
Preexisting Conditions: arrythmias, high cholesterol,
Allergies: penicillin, gentamicin,
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: Pt was seated and suddenly became flushed and reported a strange taste in her mouth. Vitals taken. BP 116/65, pulse 87, O2 99%. Pt given water and continued to observe. Pt reported feeling better.


Changed on 5/7/2021

VAERS ID: 908662 Before After
VAERS Form:2
Age:51.0
Sex:Female
Location:Arizona
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 011J2OA / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Dysgeusia, Flushing

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)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: pristiq, crestor, lyrica, zyrtec, desmopressin, bystolic
Current Illness: none
Preexisting Conditions: arrythmias, high cholesterol,
Allergies: penicillin, gentamicin, gentamicin,
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: Pt was seated and suddenly became flushed and reported a strange taste in her mouth. Vitals taken. BP 116/65, pulse 87, O2 99%. Pt given water and continued to observe. Pt reported feeling better.


Changed on 5/21/2021

VAERS ID: 908662 Before After
VAERS Form:2
Age:51.0
Sex:Female
Location:Arizona
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 011J2OA / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Dysgeusia, Flushing

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)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: pristiq, crestor, lyrica, zyrtec, desmopressin, bystolic
Current Illness: none
Preexisting Conditions: arrythmias, high cholesterol,
Allergies: penicillin, gentamicin, gentamicin,
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: Pt was seated and suddenly became flushed and reported a strange taste in her mouth. Vitals taken. BP 116/65, pulse 87, O2 99%. Pt given water and continued to observe. Pt reported feeling better.

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