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This is VAERS ID 908685

History of Changes from the VAERS Wayback Machine

First Appeared on 12/30/2020

VAERS ID: 908685
VAERS Form:2
Age:22.0
Sex:Female
Location:Arizona
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 - / UNK - / IM

Administered by: Private      Purchased by: ??
Symptoms: Supraventricular tachycardia, Pharyngeal swelling

Life Threatening? Yes
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? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Nuvaring
Current Illness: Chronic Tonsilitis Dysmenorrhea
Preexisting Conditions: N/A
Allergies: N.K.A
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: throat swelling, SVT


Changed on 5/7/2021

VAERS ID: 908685 Before After
VAERS Form:2
Age:22.0
Sex:Female
Location:Arizona
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 - / UNK - / IM

Administered by: Private      Purchased by: ??
Symptoms: Supraventricular tachycardia, Pharyngeal swelling

Life Threatening? Yes
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? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Nuvaring
Current Illness: Chronic Tonsilitis Dysmenorrhea
Preexisting Conditions: N/A
Allergies: N.K.A N.K.A
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: throat swelling, SVT


Changed on 5/14/2021

VAERS ID: 908685 Before After
VAERS Form:2
Age:22.0
Sex:Female
Location:Arizona
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 - / UNK - / IM

Administered by: Private      Purchased by: ??
Symptoms: Supraventricular tachycardia, Pharyngeal swelling

Life Threatening? Yes
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? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Nuvaring
Current Illness: Chronic Tonsilitis Dysmenorrhea
Preexisting Conditions: N/A
Allergies: N.K.A N.K.A
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: throat swelling, SVT


Changed on 6/4/2021

VAERS ID: 908685 Before After
VAERS Form:2
Age:22.0
Sex:Female
Location:Arizona
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 - / UNK - / IM

Administered by: Private      Purchased by: ??
Symptoms: Supraventricular tachycardia, Pharyngeal swelling

Life Threatening? Yes
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? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Nuvaring
Current Illness: Chronic Tonsilitis Dysmenorrhea
Preexisting Conditions: N/A
Allergies: N.K.A
Diagnostic Lab Data:
CDC 'Split Type': (blank) vsafe

Write-up: throat swelling, SVT


Changed on 7/16/2021

VAERS ID: 908685 Before After
VAERS Form:2
Age:22.0
Sex:Female
Location:Arizona
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 - / UNK - / IM

Administered by: Private      Purchased by: ??
Symptoms: Supraventricular tachycardia, Pharyngeal swelling

Life Threatening? Yes
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? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Nuvaring
Current Illness: Chronic Tonsilitis Tonsillitis Dysmenorrhea
Preexisting Conditions: N/A
Allergies: N.K.A
Diagnostic Lab Data:
CDC 'Split Type': vsafe

Write-up: throat swelling, SVT

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=908685&WAYBACKHISTORY=ON

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