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From the 10/15/2021 release of VAERS data:

This is VAERS ID 908786



Case Details

VAERS ID: 908786 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Montana  
Vaccinated:2020-12-22
Onset:2020-12-22
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2020-12-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011.720A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Chills, Fatigue, Lip swelling, Oedema peripheral, Paraesthesia oral
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: Hx of anaphylaxis during allergy testing age 9
Diagnostic Lab Data: none
CDC Split Type:

Write-up: initial fatigue, chills. After 24 hours, extreme fatigue, lips tingled, went to bed. In am, about40 hours after vaccination developed swollen upper lip and swollen armpit on side where she was vaccinated.


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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=908786

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