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This is VAERS ID 909496

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History of Changes from the VAERS Wayback Machine

First Appeared on 1/7/2021

VAERS ID: 909496
VAERS Form:2
Age:52.0
Sex:Female
Location:Colorado
Vaccinated:2020-12-23
Onset:2020-12-24
Submitted:0000-00-00
Entered:2020-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Blister, Burning sensation, Ear pain, Lymphadenopathy, Paraesthesia, Rash, Varicella zoster virus infection

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: mvi, omega 3
Current Illness: none
Preexisting Conditions: none
Allergies: vibramycin
Diagnostic Lab Data: started on Valtrex 12/26 pm, f/u with optho this week
CDC 'Split Type':

Write-up: 24 hrs- lymphadenopathy, submandibular, ear pain 36 hrs- primary outbreak of VZV- trigeminal n involvement- tingling/burning 48 hrs- rash and vesicles in trigeminal n distribution


Changed on 5/7/2021

VAERS ID: 909496 Before After
VAERS Form:2
Age:52.0
Sex:Female
Location:Colorado
Vaccinated:2020-12-23
Onset:2020-12-24
Submitted:0000-00-00
Entered:2020-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Blister, Burning sensation, Ear pain, Lymphadenopathy, Paraesthesia, Rash, Varicella zoster virus infection

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: mvi, omega 3
Current Illness: none
Preexisting Conditions: none
Allergies: vibramycin vibramycin
Diagnostic Lab Data: started on Valtrex 12/26 pm, f/u with optho this week
CDC 'Split Type':

Write-up: 24 hrs- lymphadenopathy, submandibular, ear pain 36 hrs- primary outbreak of VZV- trigeminal n involvement- tingling/burning 48 hrs- rash and vesicles in trigeminal n distribution


Changed on 5/21/2021

VAERS ID: 909496 Before After
VAERS Form:2
Age:52.0
Sex:Female
Location:Colorado
Vaccinated:2020-12-23
Onset:2020-12-24
Submitted:0000-00-00
Entered:2020-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Blister, Burning sensation, Ear pain, Lymphadenopathy, Paraesthesia, Rash, Varicella zoster virus infection

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: mvi, omega 3
Current Illness: none
Preexisting Conditions: none
Allergies: vibramycin vibramycin
Diagnostic Lab Data: started on Valtrex 12/26 pm, f/u with optho this week
CDC 'Split Type':

Write-up: 24 hrs- lymphadenopathy, submandibular, ear pain 36 hrs- primary outbreak of VZV- trigeminal n involvement- tingling/burning 48 hrs- rash and vesicles in trigeminal n distribution

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=909496&WAYBACKHISTORY=ON


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