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This is VAERS ID 909464

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History of Changes from the VAERS Wayback Machine

First Appeared on 1/7/2021

VAERS ID: 909464
VAERS Form:2
Age:34.0
Sex:Female
Location:Colorado
Vaccinated:2020-12-23
Onset:2020-12-23
Submitted:0000-00-00
Entered:2020-12-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011J20A / 1 RA / -

Administered by: Military      Purchased by: ??
Symptoms: Dysphagia, Injection site pain, Injection site pruritus, Injection site rash, Rash, Swollen tongue

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)? Yes
Hospitalized? No
Previous Vaccinations: Pneumovax 23; 2011; Cellulitis
Other Medications: Armour Thyroid 30mg 1QAM Armour Thyroid 120mcg 1QAM Aspirin EC 81mg 1QAM Latuda 40mg 1QPM Lamictal XR 200mg 1QPM Lithium 300mg Cap 2QPM Diazepam 5mg 1Q8H PRN Anxiety Nurtec ODT 75mg Botox Injections (Migraines) Ibuprofen 800mg 1Q8H PRN Hea
Current Illness: None known
Preexisting Conditions: Hashimoto?s Hypothyroidism; Intracranial Stents (Right ICA and Left ICA); Manic Depression; Bipolar I; Obsessive-Compulsive Personality Disorder; Migraines
Allergies: Latex, penicillins, zolmitriptan
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: Within minutes of innoculation, site area became extremely itchy. I brought this to the attention of the medics in the 15-minute observation room, and they immediately took me to an exam room where I was attentively cared for by several nurses, medics, and healthcare staff. I was given liquid Benedryl as my arm began to rash around the site. Within about five minutes of being in the exam room, my tongue began to feel like it was swelling in the back of my mouth, it soon began to feel swollen through the whole tongue, and it became increasingly difficult to swallow. Upon notifying the nurse nearby, I was immediately given an EpiPen injection. I do not know what may vitals were as everything happened very quickly, but I was told that my face, neck, and chest became rashy quickly, but subsided after several minutes from the EpiPen, at which time I was given more liquid Benadryl. Once stable, I was taken to the emergency room for monitoring for two hours. I felt better quite quickly after arriving in the emergency room, but the itching persisted through the evening. After 15 hours of sleep, I awoke to only a sore arm and thigh from each injection site.


Changed on 5/7/2021

VAERS ID: 909464 Before After
VAERS Form:2
Age:34.0
Sex:Female
Location:Colorado
Vaccinated:2020-12-23
Onset:2020-12-23
Submitted:0000-00-00
Entered:2020-12-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011J20A / 1 RA / -

Administered by: Military      Purchased by: ??
Symptoms: Dysphagia, Injection site pain, Injection site pruritus, Injection site rash, Rash, Swollen tongue

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)? Yes
Hospitalized? No
Previous Vaccinations: Pneumovax 23; 2011; Cellulitis
Other Medications: Armour Thyroid 30mg 1QAM Armour Thyroid 120mcg 1QAM Aspirin EC 81mg 1QAM Latuda 40mg 1QPM Lamictal XR 200mg 1QPM Lithium 300mg Cap 2QPM Diazepam 5mg 1Q8H PRN Anxiety Nurtec ODT 75mg Botox Injections (Migraines) Ibuprofen 800mg 1Q8H PRN Hea
Current Illness: None known
Preexisting Conditions: Hashimoto?s Hypothyroidism; Intracranial Stents (Right ICA and Left ICA); Manic Depression; Bipolar I; Obsessive-Compulsive Personality Disorder; Migraines
Allergies: Latex, penicillins, zolmitriptan zolmitriptan
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: Within minutes of innoculation, site area became extremely itchy. I brought this to the attention of the medics in the 15-minute observation room, and they immediately took me to an exam room where I was attentively cared for by several nurses, medics, and healthcare staff. I was given liquid Benedryl as my arm began to rash around the site. Within about five minutes of being in the exam room, my tongue began to feel like it was swelling in the back of my mouth, it soon began to feel swollen through the whole tongue, and it became increasingly difficult to swallow. Upon notifying the nurse nearby, I was immediately given an EpiPen injection. I do not know what may vitals were as everything happened very quickly, but I was told that my face, neck, and chest became rashy quickly, but subsided after several minutes from the EpiPen, at which time I was given more liquid Benadryl. Once stable, I was taken to the emergency room for monitoring for two hours. I felt better quite quickly after arriving in the emergency room, but the itching persisted through the evening. After 15 hours of sleep, I awoke to only a sore arm and thigh from each injection site.


Changed on 5/21/2021

VAERS ID: 909464 Before After
VAERS Form:2
Age:34.0
Sex:Female
Location:Colorado
Vaccinated:2020-12-23
Onset:2020-12-23
Submitted:0000-00-00
Entered:2020-12-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011J20A / 1 RA / -

Administered by: Military      Purchased by: ??
Symptoms: Dysphagia, Injection site pain, Injection site pruritus, Injection site rash, Rash, Swollen tongue

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)? Yes
Hospitalized? No
Previous Vaccinations: Pneumovax 23; 2011; Cellulitis
Other Medications: Armour Thyroid 30mg 1QAM Armour Thyroid 120mcg 1QAM Aspirin EC 81mg 1QAM Latuda 40mg 1QPM Lamictal XR 200mg 1QPM Lithium 300mg Cap 2QPM Diazepam 5mg 1Q8H PRN Anxiety Nurtec ODT 75mg Botox Injections (Migraines) Ibuprofen 800mg 1Q8H PRN Hea
Current Illness: None known
Preexisting Conditions: Hashimoto?s Hypothyroidism; Intracranial Stents (Right ICA and Left ICA); Manic Depression; Bipolar I; Obsessive-Compulsive Personality Disorder; Migraines
Allergies: Latex, penicillins, zolmitriptan zolmitriptan
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: Within minutes of innoculation, site area became extremely itchy. I brought this to the attention of the medics in the 15-minute observation room, and they immediately took me to an exam room where I was attentively cared for by several nurses, medics, and healthcare staff. I was given liquid Benedryl as my arm began to rash around the site. Within about five minutes of being in the exam room, my tongue began to feel like it was swelling in the back of my mouth, it soon began to feel swollen through the whole tongue, and it became increasingly difficult to swallow. Upon notifying the nurse nearby, I was immediately given an EpiPen injection. I do not know what may vitals were as everything happened very quickly, but I was told that my face, neck, and chest became rashy quickly, but subsided after several minutes from the EpiPen, at which time I was given more liquid Benadryl. Once stable, I was taken to the emergency room for monitoring for two hours. I felt better quite quickly after arriving in the emergency room, but the itching persisted through the evening. After 15 hours of sleep, I awoke to only a sore arm and thigh from each injection site.

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