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This is VAERS ID 912869

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History of Changes from the VAERS Wayback Machine

First Appeared on 1/22/2021

VAERS ID: 912869
VAERS Form:2
Age:18.0
Sex:Female
Location:Ohio
Vaccinated:2020-12-28
Onset:2020-12-29
Submitted:0000-00-00
Entered:2020-12-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

Administered by: Senior Living      Purchased by: ??
Symptoms: Chills, Fatigue, Migraine, Myalgia, Pain, Tenderness, Vaccination site swelling

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Strong migraines, fatigue, muscle pain, chills. Pain, tenderness, and swelling at vaccine sight.


Changed on 5/7/2021

VAERS ID: 912869 Before After
VAERS Form:2
Age:18.0
Sex:Female
Location:Ohio
Vaccinated:2020-12-28
Onset:2020-12-29
Submitted:0000-00-00
Entered:2020-12-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

Administered by: Senior Living      Purchased by: ??
Symptoms: Chills, Fatigue, Migraine, Myalgia, Pain, Tenderness, Vaccination site swelling

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Strong migraines, fatigue, muscle pain, chills. Pain, tenderness, and swelling at vaccine sight.


Changed on 5/14/2021

VAERS ID: 912869 Before After
VAERS Form:2
Age:18.0
Sex:Female
Location:Ohio
Vaccinated:2020-12-28
Onset:2020-12-29
Submitted:0000-00-00
Entered:2020-12-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

Administered by: Senior Living      Purchased by: ??
Symptoms: Chills, Fatigue, Migraine, Myalgia, Pain, Tenderness, Vaccination site swelling

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Strong migraines, fatigue, muscle pain, chills. Pain, tenderness, and swelling at vaccine sight.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=912869&WAYBACKHISTORY=ON


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