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This is VAERS ID 918538

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History of Changes from the VAERS Wayback Machine

First Appeared on 2/18/2021

VAERS ID: 918538
VAERS Form:2
Age:19.0
Sex:Female
Location:Texas
Vaccinated:2020-12-29
Onset:2020-12-30
Submitted:0000-00-00
Entered:2021-01-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025L20A / 1 AR / IM

Administered by: Private      Purchased by: ??
Symptoms: Flushing, Nausea, Sleep disorder, Urticaria

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)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: "Woke up at 1am with nausea, flushed in the face, hives and bumps on face and back. Lasting approximately 4-5 hours"


Changed on 5/7/2021

VAERS ID: 918538 Before After
VAERS Form:2
Age:19.0
Sex:Female
Location:Texas
Vaccinated:2020-12-29
Onset:2020-12-30
Submitted:0000-00-00
Entered:2021-01-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025L20A / 1 AR / IM

Administered by: Private      Purchased by: ??
Symptoms: Flushing, Nausea, Sleep disorder, Urticaria

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)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: "Woke up at 1am with nausea, flushed in the face, hives and bumps on face and back. Lasting approximately 4-5 hours"


Changed on 5/21/2021

VAERS ID: 918538 Before After
VAERS Form:2
Age:19.0
Sex:Female
Location:Texas
Vaccinated:2020-12-29
Onset:2020-12-30
Submitted:0000-00-00
Entered:2021-01-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025L20A / 1 AR / IM

Administered by: Private      Purchased by: ??
Symptoms: Flushing, Nausea, Sleep disorder, Urticaria

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)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: "Woke up at 1am with nausea, flushed in the face, hives and bumps on face and back. Lasting approximately 4-5 hours"

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