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This is VAERS ID 917722

History of Changes from the VAERS Wayback Machine

First Appeared on 2/18/2021

VAERS ID: 917722
VAERS Form:2
Age:36.0
Sex:Female
Location:Florida
Vaccinated:2020-12-28
Onset:2020-12-28
Submitted:0000-00-00
Entered:2021-01-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Heart rate increased, Mouth haemorrhage, Palpitations, Petechiae, Rash, Rash erythematous, Rash vesicular, Enlarged uvula, Oropharyngeal pain

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: Nexium, Pepcid, Tumeric/ginger tea, Tylenol, ibuprofen
Current Illness: None
Preexisting Conditions: GERD
Allergies: Bactrim
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: Received shot at 11:45 am. At 1700 that day developed sensation of racing heart and resting heart rate was 120. Baseline heart rate 80 at rest. This resolved overnight and returned to normal the next day. On 12/31/2020 develop sore throat and noted red vesicle like rash on my throat with petechia on my cheeks (buccal mucosa) and tongue. Swollen uvula. I had a medrol dose pack and Benadryl which I started immediately and rash/sore throat petechia resovlved 36 hours after starting the Medro dose pack. Unsure if this was related the vaccine but wanted to report just in case.


Changed on 5/7/2021

VAERS ID: 917722 Before After
VAERS Form:2
Age:36.0
Sex:Female
Location:Florida
Vaccinated:2020-12-28
Onset:2020-12-28
Submitted:0000-00-00
Entered:2021-01-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Heart rate increased, Mouth haemorrhage, Palpitations, Petechiae, Rash, Rash erythematous, Rash vesicular, Enlarged uvula, Oropharyngeal pain

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: Nexium, Pepcid, Tumeric/ginger tea, Tylenol, ibuprofen
Current Illness: None
Preexisting Conditions: GERD
Allergies: Bactrim Bactrim
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: Received shot at 11:45 am. At 1700 that day developed sensation of racing heart and resting heart rate was 120. Baseline heart rate 80 at rest. This resolved overnight and returned to normal the next day. On 12/31/2020 develop sore throat and noted red vesicle like rash on my throat with petechia on my cheeks (buccal mucosa) and tongue. Swollen uvula. I had a medrol dose pack and Benadryl which I started immediately and rash/sore throat petechia resovlved 36 hours after starting the Medro dose pack. Unsure if this was related the vaccine but wanted to report just in case.


Changed on 5/14/2021

VAERS ID: 917722 Before After
VAERS Form:2
Age:36.0
Sex:Female
Location:Florida
Vaccinated:2020-12-28
Onset:2020-12-28
Submitted:0000-00-00
Entered:2021-01-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Heart rate increased, Mouth haemorrhage, Palpitations, Petechiae, Rash, Rash erythematous, Rash vesicular, Enlarged uvula, Oropharyngeal pain

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: Nexium, Pepcid, Tumeric/ginger tea, Tylenol, ibuprofen
Current Illness: None
Preexisting Conditions: GERD
Allergies: Bactrim Bactrim
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: Received shot at 11:45 am. At 1700 that day developed sensation of racing heart and resting heart rate was 120. Baseline heart rate 80 at rest. This resolved overnight and returned to normal the next day. On 12/31/2020 develop sore throat and noted red vesicle like rash on my throat with petechia on my cheeks (buccal mucosa) and tongue. Swollen uvula. I had a medrol dose pack and Benadryl which I started immediately and rash/sore throat petechia resovlved 36 hours after starting the Medro dose pack. Unsure if this was related the vaccine but wanted to report just in case.

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