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This is VAERS ID 909384

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History of Changes from the VAERS Wayback Machine

First Appeared on 1/7/2021

VAERS ID: 909384
VAERS Form:2
Age:59.0
Sex:Female
Location:New York
Vaccinated:2020-12-23
Onset:2020-12-24
Submitted:0000-00-00
Entered:2020-12-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 016120A / 1 LA / SYR

Administered by: Work      Purchased by: ??
Symptoms: Arthralgia, Chills, Fatigue, Injection site pain, Pain, Pyrexia, Rash erythematous

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Omega 3 Vit d
Current Illness: No
Preexisting Conditions: No
Allergies: No
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Felt fine day of shot. Next day low fever 100.6 chills, tired , generalized aches rap hand joints. Now arm soreness atvi jection site and a red small rash distal to site


Changed on 5/7/2021

VAERS ID: 909384 Before After
VAERS Form:2
Age:59.0
Sex:Female
Location:New York
Vaccinated:2020-12-23
Onset:2020-12-24
Submitted:0000-00-00
Entered:2020-12-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 016120A / 1 LA / SYR

Administered by: Work      Purchased by: ??
Symptoms: Arthralgia, Chills, Fatigue, Injection site pain, Pain, Pyrexia, Rash erythematous

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Omega 3 Vit d
Current Illness: No
Preexisting Conditions: No
Allergies: No No
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Felt fine day of shot. Next day low fever 100.6 chills, tired , generalized aches rap hand joints. Now arm soreness atvi jection site and a red small rash distal to site


Changed on 5/21/2021

VAERS ID: 909384 Before After
VAERS Form:2
Age:59.0
Sex:Female
Location:New York
Vaccinated:2020-12-23
Onset:2020-12-24
Submitted:0000-00-00
Entered:2020-12-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 016120A / 1 LA / SYR

Administered by: Work      Purchased by: ??
Symptoms: Arthralgia, Chills, Fatigue, Injection site pain, Pain, Pyrexia, Rash erythematous

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Omega 3 Vit d
Current Illness: No
Preexisting Conditions: No
Allergies: No No
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Felt fine day of shot. Next day low fever 100.6 chills, tired , generalized aches rap hand joints. Now arm soreness atvi jection site and a red small rash distal to site

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