National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts.org
Search Results

From the 1/14/2022 release of VAERS data:

This is VAERS ID 909373

Government Disclaimer on use of this data



Case Details

VAERS ID: 909373 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: New York  
Vaccinated:2020-12-24
Onset:2020-12-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2020-12-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025JO2A / 1 RA / IM

Administered by: Work       Purchased by: ?
Symptoms: Back pain, Burning sensation, Fatigue, Headache, Neck pain, Pain in extremity, Rash erythematous, Tenderness
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Retroperitoneal fibrosis (broad), Hypersensitivity (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad), 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: Vit D3 1000 U Vit B12 250 mcg zyrtec 10 mg
Current Illness: none
Preexisting Conditions: seasonal allergies
Allergies: presumed allergy to shellfish, not confirmed
Diagnostic Lab Data: none
CDC Split Type:

Write-up: dose 1 of vaccine at 11am 12/24/20, after vaccination I noticed some pain and burning that radiated down arm, lasted for seconds and resolved. This pain came and went throughout afternoon of 12/24. Upon waking around 730am on 12/25/20 I noticed slightly red erythematous ovoid rash that measured approx 3 in x 1 in in size, was exquisitely tender to touch, but smooth, without vesicles, pustules, non-fluctuant. Took tylenol and applied heat to area without relief of pain. Pain is burning in nature, with a soreness that radiates down the back of my upper arm. Pain worse with raising or using arm. Also have aching in neck and upper back. Also having increased fatigue and slight headache all of 12/25, worst at night and located on right side of head, throbbing. On 12.26.20 I woke and noticed rash has slightly increased from markings made on 12/25/20. I continue to feel tired, achy, with slight headache. Arm very sore and upper back very sore.


New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=909373


Copyright © 2022 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166