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This is VAERS ID 909488

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History of Changes from the VAERS Wayback Machine

First Appeared on 1/7/2021

VAERS ID: 909488
VAERS Form:2
Age:32.0
Sex:Female
Location:Pennsylvania
Vaccinated:2020-12-24
Onset:2020-12-26
Submitted:0000-00-00
Entered:2020-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

Administered by: Public      Purchased by: ??
Symptoms: Heart rate increased, Hyperventilation, Mental impairment, Pain in extremity

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: Soreness at site of injection
Other Medications: Daily vitamin, msm capsules 2 a day, wellness capsules 3 a day
Current Illness:
Preexisting Conditions: Pre diabetic this is recent.
Allergies: None
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Aching arm, loss of train of thought, deeper breathing, steady increase in heart rate with the occasional drop in heart rate.


Changed on 5/7/2021

VAERS ID: 909488 Before After
VAERS Form:2
Age:32.0
Sex:Female
Location:Pennsylvania
Vaccinated:2020-12-24
Onset:2020-12-26
Submitted:0000-00-00
Entered:2020-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

Administered by: Public      Purchased by: ??
Symptoms: Heart rate increased, Hyperventilation, Mental impairment, Pain in extremity

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: Soreness at site of injection
Other Medications: Daily vitamin, msm capsules 2 a day, wellness capsules 3 a day
Current Illness:
Preexisting Conditions: Pre diabetic this is recent.
Allergies: None None
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Aching arm, loss of train of thought, deeper breathing, steady increase in heart rate with the occasional drop in heart rate.


Changed on 5/21/2021

VAERS ID: 909488 Before After
VAERS Form:2
Age:32.0
Sex:Female
Location:Pennsylvania
Vaccinated:2020-12-24
Onset:2020-12-26
Submitted:0000-00-00
Entered:2020-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

Administered by: Public      Purchased by: ??
Symptoms: Heart rate increased, Hyperventilation, Mental impairment, Pain in extremity

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: Soreness at site of injection
Other Medications: Daily vitamin, msm capsules 2 a day, wellness capsules 3 a day
Current Illness:
Preexisting Conditions: Pre diabetic this is recent.
Allergies: None None
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Aching arm, loss of train of thought, deeper breathing, steady increase in heart rate with the occasional drop in heart rate.

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