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This is VAERS ID 913568

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History of Changes from the VAERS Wayback Machine

First Appeared on 1/29/2021

VAERS ID: 913568
VAERS Form:2
Age:19.0
Sex:Female
Location:Arkansas
Vaccinated:2020-12-29
Onset:2020-12-29
Submitted:0000-00-00
Entered:2020-12-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 RA / IM

Administered by: Senior Living      Purchased by: ??
Symptoms: Dizziness, Feeling hot, Heart rate increased, Injection site pain, Injection site rash, Nausea, Paraesthesia, Hot flush

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: Protonix
Current Illness: Shortness of breath in the last month
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: Nausea, "felt hot", light headed, dizzy, face tingling, elevated heart rate, rash to arm of injection site, soreness to injection site. Stayed for observation. Currently having on and off "hot flashes", and slightly light headed. Other symptoms have resolved.


Changed on 5/7/2021

VAERS ID: 913568 Before After
VAERS Form:2
Age:19.0
Sex:Female
Location:Arkansas
Vaccinated:2020-12-29
Onset:2020-12-29
Submitted:0000-00-00
Entered:2020-12-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 RA / IM

Administered by: Senior Living      Purchased by: ??
Symptoms: Dizziness, Feeling hot, Heart rate increased, Injection site pain, Injection site rash, Nausea, Paraesthesia, Hot flush

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: Protonix
Current Illness: Shortness of breath in the last month
Preexisting Conditions: None
Allergies: None None
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: Nausea, "felt hot", light headed, dizzy, face tingling, elevated heart rate, rash to arm of injection site, soreness to injection site. Stayed for observation. Currently having on and off "hot flashes", and slightly light headed. Other symptoms have resolved.


Changed on 5/14/2021

VAERS ID: 913568 Before After
VAERS Form:2
Age:19.0
Sex:Female
Location:Arkansas
Vaccinated:2020-12-29
Onset:2020-12-29
Submitted:0000-00-00
Entered:2020-12-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 RA / IM

Administered by: Senior Living      Purchased by: ??
Symptoms: Dizziness, Feeling hot, Heart rate increased, Injection site pain, Injection site rash, Nausea, Paraesthesia, Hot flush

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: Protonix
Current Illness: Shortness of breath in the last month
Preexisting Conditions: None
Allergies: None None
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: Nausea, "felt hot", light headed, dizzy, face tingling, elevated heart rate, rash to arm of injection site, soreness to injection site. Stayed for observation. Currently having on and off "hot flashes", and slightly light headed. Other symptoms have resolved.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=913568&WAYBACKHISTORY=ON


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