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This is VAERS ID 917855

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History of Changes from the VAERS Wayback Machine

First Appeared on 1/7/2021

VAERS ID: 917855
VAERS Form:2
Age:47.0
Sex:Female
Location:California
Vaccinated:2020-12-31
Onset:2021-01-01
Submitted:0000-00-00
Entered:2021-01-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 039K20A / 1 LA / IM

Administered by: Work      Purchased by: ??
Symptoms: Chest X-ray, Differential white blood cell count, Electrocardiogram, Full blood count, Palpitations, Pyrexia, Metabolic function test, Human chorionic gonadotropin

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)? Yes
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE. HOWEVER I DID TAKE BENADRYL PROPHYLACTICALLY JUST IN CASE BECAUSE I HEARD OF PEOPLE HAVING ADVERSE REACTIONS TO BOTH MODERNA AND PFIZER COVID VACCINE.
Current Illness: NONE
Preexisting Conditions: NONE
Allergies: SULFA
Diagnostic Lab Data: CBC WITH DIFFERENTIAL, COMPREHENSIVE METABOLIC PANEL, HCG QUANTITATIVE, ECG 12 LEAD, CHEST X-RAY, TYLENOL, IV OF NORMAL SALINE
CDC 'Split Type':

Write-up: ON 1/1/21 THE DAY AFTER I RECEIVED THE VACCINE I WAS TAKING A NAP AND MY WATCH KEPT SENDING ME ALERTS. HOWEVER I DID NOT CHECK MY WATCH UNTIL 5:30 WHEN I WOKE UP AND I FELT LIKE I WAS HAVING HEART PALPITATIONS. I WENT TO THE EMERGENCY ROOM WHERE I WAS TREATED. I WAS TOLD THAT I WAS FEBRILE WITH A TEMPERATURE OF 102. I WAS GIVEN IV FLUIDS, CHEST X-RAY, EKG AND LAB WORK. I WAS RELEASED ON 1/2/21 AT APPROXIMATELY 0030 (MIDNIGHT).


Changed on 5/7/2021

VAERS ID: 917855 Before After
VAERS Form:2
Age:47.0
Sex:Female
Location:California
Vaccinated:2020-12-31
Onset:2021-01-01
Submitted:0000-00-00
Entered:2021-01-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 039K20A / 1 LA / IM

Administered by: Work      Purchased by: ??
Symptoms: Chest X-ray, Differential white blood cell count, Electrocardiogram, Full blood count, Palpitations, Pyrexia, Metabolic function test, Human chorionic gonadotropin

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)? Yes
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE. HOWEVER I DID TAKE BENADRYL PROPHYLACTICALLY JUST IN CASE BECAUSE I HEARD OF PEOPLE HAVING ADVERSE REACTIONS TO BOTH MODERNA AND PFIZER COVID VACCINE.
Current Illness: NONE
Preexisting Conditions: NONE
Allergies: SULFA SULFA
Diagnostic Lab Data: CBC WITH DIFFERENTIAL, COMPREHENSIVE METABOLIC PANEL, HCG QUANTITATIVE, ECG 12 LEAD, CHEST X-RAY, TYLENOL, IV OF NORMAL SALINE
CDC 'Split Type':

Write-up: ON 1/1/21 THE DAY AFTER I RECEIVED THE VACCINE I WAS TAKING A NAP AND MY WATCH KEPT SENDING ME ALERTS. HOWEVER I DID NOT CHECK MY WATCH UNTIL 5:30 WHEN I WOKE UP AND I FELT LIKE I WAS HAVING HEART PALPITATIONS. I WENT TO THE EMERGENCY ROOM WHERE I WAS TREATED. I WAS TOLD THAT I WAS FEBRILE WITH A TEMPERATURE OF 102. I WAS GIVEN IV FLUIDS, CHEST X-RAY, EKG AND LAB WORK. I WAS RELEASED ON 1/2/21 AT APPROXIMATELY 0030 (MIDNIGHT).


Changed on 5/14/2021

VAERS ID: 917855 Before After
VAERS Form:2
Age:47.0
Sex:Female
Location:California
Vaccinated:2020-12-31
Onset:2021-01-01
Submitted:0000-00-00
Entered:2021-01-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 039K20A / 1 LA / IM

Administered by: Work      Purchased by: ??
Symptoms: Chest X-ray, Differential white blood cell count, Electrocardiogram, Full blood count, Palpitations, Pyrexia, Metabolic function test, Human chorionic gonadotropin

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)? Yes
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE. HOWEVER I DID TAKE BENADRYL PROPHYLACTICALLY JUST IN CASE BECAUSE I HEARD OF PEOPLE HAVING ADVERSE REACTIONS TO BOTH MODERNA AND PFIZER COVID VACCINE.
Current Illness: NONE
Preexisting Conditions: NONE
Allergies: SULFA SULFA
Diagnostic Lab Data: CBC WITH DIFFERENTIAL, COMPREHENSIVE METABOLIC PANEL, HCG QUANTITATIVE, ECG 12 LEAD, CHEST X-RAY, TYLENOL, IV OF NORMAL SALINE
CDC 'Split Type':

Write-up: ON 1/1/21 THE DAY AFTER I RECEIVED THE VACCINE I WAS TAKING A NAP AND MY WATCH KEPT SENDING ME ALERTS. HOWEVER I DID NOT CHECK MY WATCH UNTIL 5:30 WHEN I WOKE UP AND I FELT LIKE I WAS HAVING HEART PALPITATIONS. I WENT TO THE EMERGENCY ROOM WHERE I WAS TREATED. I WAS TOLD THAT I WAS FEBRILE WITH A TEMPERATURE OF 102. I WAS GIVEN IV FLUIDS, CHEST X-RAY, EKG AND LAB WORK. I WAS RELEASED ON 1/2/21 AT APPROXIMATELY 0030 (MIDNIGHT).

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