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This is VAERS ID 908700

History of Changes from the VAERS Wayback Machine

First Appeared on 1/7/2021

VAERS ID: 908700
VAERS Form:2
Age:23.0
Sex:Female
Location:Texas
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: Chills, Dizziness, Tremor, Urticaria, Immediate post-injection reaction

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)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Lisinopril, diclofenac
Current Illness: none
Preexisting Conditions: HTN, arthritis
Allergies: none
Diagnostic Lab Data: n/a
CDC 'Split Type':

Write-up: Developed tremor, dizziness, and chills almost immediately after vaccine. She developed hives to her chest approximately 30 mins after the vaccine was given. She did get IM benadryl in the office which resolved the hives. She was transported to the hospital via ambulance as the dizziness and tremor worsened over the time she was in the clinic. She was discharged from ER the same day.


Changed on 5/7/2021

VAERS ID: 908700 Before After
VAERS Form:2
Age:23.0
Sex:Female
Location:Texas
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: Chills, Dizziness, Tremor, Urticaria, Immediate post-injection reaction

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)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Lisinopril, diclofenac
Current Illness: none
Preexisting Conditions: HTN, arthritis
Allergies: none none
Diagnostic Lab Data: n/a
CDC 'Split Type':

Write-up: Developed tremor, dizziness, and chills almost immediately after vaccine. She developed hives to her chest approximately 30 mins after the vaccine was given. She did get IM benadryl in the office which resolved the hives. She was transported to the hospital via ambulance as the dizziness and tremor worsened over the time she was in the clinic. She was discharged from ER the same day.


Changed on 5/14/2021

VAERS ID: 908700 Before After
VAERS Form:2
Age:23.0
Sex:Female
Location:Texas
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: Chills, Dizziness, Tremor, Urticaria, Immediate post-injection reaction

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)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Lisinopril, diclofenac
Current Illness: none
Preexisting Conditions: HTN, arthritis
Allergies: none none
Diagnostic Lab Data: n/a
CDC 'Split Type':

Write-up: Developed tremor, dizziness, and chills almost immediately after vaccine. She developed hives to her chest approximately 30 mins after the vaccine was given. She did get IM benadryl in the office which resolved the hives. She was transported to the hospital via ambulance as the dizziness and tremor worsened over the time she was in the clinic. She was discharged from ER the same day.

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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=908700&WAYBACKHISTORY=ON

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