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This is VAERS ID 909553

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History of Changes from the VAERS Wayback Machine

First Appeared on 1/7/2021

VAERS ID: 909553
VAERS Form:2
Age:46.0
Sex:Female
Location:Ohio
Vaccinated:2020-12-26
Onset:2020-12-26
Submitted:0000-00-00
Entered:2020-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 039K20A / UNK RA / IM

Administered by: Public      Purchased by: ??
Symptoms: Dysgeusia, Flushing, Hypoaesthesia oral, Paraesthesia oral

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: Cozaar
Current Illness: None
Preexisting Conditions: High BP
Allergies: Allergic to Augmentin, Zpak, Erythromycin
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Received Moderna vaccine at approximately 4:05pm on 12/26/2020. Within 15 minutes, developed flushed feeling throughout body, developed strange taste in mouth, mouth and tongue felt numb and tingly. Was given 2 Benadryl, symptoms improved, resolved within 6 hours.


Changed on 5/7/2021

VAERS ID: 909553 Before After
VAERS Form:2
Age:46.0
Sex:Female
Location:Ohio
Vaccinated:2020-12-26
Onset:2020-12-26
Submitted:0000-00-00
Entered:2020-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 039K20A / UNK RA / IM

Administered by: Public      Purchased by: ??
Symptoms: Dysgeusia, Flushing, Hypoaesthesia oral, Paraesthesia oral

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: Cozaar
Current Illness: None
Preexisting Conditions: High BP
Allergies: Allergic to Augmentin, Zpak, Erythromycin Erythromycin
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Received Moderna vaccine at approximately 4:05pm on 12/26/2020. Within 15 minutes, developed flushed feeling throughout body, developed strange taste in mouth, mouth and tongue felt numb and tingly. Was given 2 Benadryl, symptoms improved, resolved within 6 hours.


Changed on 5/21/2021

VAERS ID: 909553 Before After
VAERS Form:2
Age:46.0
Sex:Female
Location:Ohio
Vaccinated:2020-12-26
Onset:2020-12-26
Submitted:0000-00-00
Entered:2020-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 039K20A / UNK RA / IM

Administered by: Public      Purchased by: ??
Symptoms: Dysgeusia, Flushing, Hypoaesthesia oral, Paraesthesia oral

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: Cozaar
Current Illness: None
Preexisting Conditions: High BP
Allergies: Allergic to Augmentin, Zpak, Erythromycin Erythromycin
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Received Moderna vaccine at approximately 4:05pm on 12/26/2020. Within 15 minutes, developed flushed feeling throughout body, developed strange taste in mouth, mouth and tongue felt numb and tingly. Was given 2 Benadryl, symptoms improved, resolved within 6 hours.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=909553&WAYBACKHISTORY=ON


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