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This is VAERS ID 914673

History of Changes from the VAERS Wayback Machine

First Appeared on 2/12/2021

VAERS ID: 914673
VAERS Form:2
Age:54.0
Sex:Female
Location:Massachusetts
Vaccinated:2020-12-28
Onset:2020-12-28
Submitted:0000-00-00
Entered:2020-12-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Private      Purchased by: ??
Symptoms: Ecchymosis, Purpura

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: Abilify, diclofenac gel, lamictal, lorazepam, metro gel, naltrexone, naproxen, omperazole, promethrazine, propranolol, nurtec, topamax, trazodone
Current Illness: None
Preexisting Conditions: Bipolar d/o, DM, GERD, migrianes
Allergies: Neurontin (anaphylaxis), clinda (rash), geodon (fainting), imitrex (rash at injection site), pen , prozac, sulfa
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: 5-6 cm very round purpuric lesion/ecchoymosis with central clearing


Changed on 5/7/2021

VAERS ID: 914673 Before After
VAERS Form:2
Age:54.0
Sex:Female
Location:Massachusetts
Vaccinated:2020-12-28
Onset:2020-12-28
Submitted:0000-00-00
Entered:2020-12-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Private      Purchased by: ??
Symptoms: Ecchymosis, Purpura

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: Abilify, diclofenac gel, lamictal, lorazepam, metro gel, naltrexone, naproxen, omperazole, promethrazine, propranolol, nurtec, topamax, trazodone
Current Illness: None
Preexisting Conditions: Bipolar d/o, DM, GERD, migrianes
Allergies: Neurontin (anaphylaxis), clinda (rash), geodon (fainting), imitrex (rash at injection site), pen , prozac, sulfa sulfa
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: 5-6 cm very round purpuric lesion/ecchoymosis with central clearing


Changed on 5/14/2021

VAERS ID: 914673 Before After
VAERS Form:2
Age:54.0
Sex:Female
Location:Massachusetts
Vaccinated:2020-12-28
Onset:2020-12-28
Submitted:0000-00-00
Entered:2020-12-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Private      Purchased by: ??
Symptoms: Ecchymosis, Purpura

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: Abilify, diclofenac gel, lamictal, lorazepam, metro gel, naltrexone, naproxen, omperazole, promethrazine, propranolol, nurtec, topamax, trazodone
Current Illness: None
Preexisting Conditions: Bipolar d/o, DM, GERD, migrianes
Allergies: Neurontin (anaphylaxis), clinda (rash), geodon (fainting), imitrex (rash at injection site), pen , prozac, sulfa sulfa
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: 5-6 cm very round purpuric lesion/ecchoymosis with central clearing

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=914673&WAYBACKHISTORY=ON


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