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 909528

Government Disclaimer on use of this data



Case Details

VAERS ID: 909528 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Washington  
Vaccinated:2020-12-24
Onset:2020-12-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2020-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037K20A / 7+ LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Arthritis, Fatigue, Pruritus, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Systemic lupus erythematosus (broad), Hypersensitivity (narrow), Arthritis (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (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: None
Current Illness: None
Preexisting Conditions: Mild Osteoarthritis
Allergies: Bee Stings Ragweed Pollens Cat Dander
Diagnostic Lab Data: None
CDC Split Type:

Write-up: General Itchiness, fatigue, joint inflammation, worsening hives on trunk and extremeties


New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=909528


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