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This is VAERS ID 909346

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History of Changes from the VAERS Wayback Machine

First Appeared on 1/7/2021

VAERS ID: 909346
VAERS Form:2
Age:60.0
Sex:Female
Location:Pennsylvania
Vaccinated:2020-12-26
Onset:2020-12-26
Submitted:0000-00-00
Entered:2020-12-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 039K20-2A / 1 RA / IM

Administered by: Private      Purchased by: ??
Symptoms: Tinnitus, Urticaria

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? Yes
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: Motrin
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Facial hives, ear ringing, happened around 1 hr and 30 min after vaccination


Changed on 5/7/2021

VAERS ID: 909346 Before After
VAERS Form:2
Age:60.0
Sex:Female
Location:Pennsylvania
Vaccinated:2020-12-26
Onset:2020-12-26
Submitted:0000-00-00
Entered:2020-12-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 039K20-2A / 1 RA / IM

Administered by: Private      Purchased by: ??
Symptoms: Tinnitus, Urticaria

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? Yes
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: Motrin Motrin
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Facial hives, ear ringing, happened around 1 hr and 30 min after vaccination


Changed on 5/21/2021

VAERS ID: 909346 Before After
VAERS Form:2
Age:60.0
Sex:Female
Location:Pennsylvania
Vaccinated:2020-12-26
Onset:2020-12-26
Submitted:0000-00-00
Entered:2020-12-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 039K20-2A / 1 RA / IM

Administered by: Private      Purchased by: ??
Symptoms: Tinnitus, Urticaria

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? Yes
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: Motrin Motrin
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Facial hives, ear ringing, happened around 1 hr and 30 min after vaccination

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