National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

From the 9/17/2021 release of VAERS data:

This is VAERS ID 919179



Case Details

VAERS ID: 919179 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Alabama  
Vaccinated:2020-12-28
Onset:2020-12-30
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-01-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA D11J20A / 1 LA / SYR

Administered by: Work       Purchased by: ?
Symptoms: Burning sensation, Full blood count, Musculoskeletal discomfort, Nausea, Petechiae, Rash, SARS-CoV-2 test
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Haemorrhage terms (excl laboratory terms) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: mult vite C, zinc, black colash, biotin, mult collagen protein
Current Illness: no
Preexisting Conditions: no
Allergies: sulfa
Diagnostic Lab Data: CBC, COVID rapid test. ** outpatient CBC and covid rapid test completed while at work***
CDC Split Type:

Write-up: day 2 vaccine I woke up with rash all over my body except for face. No itch it burned with heat. day 4 petechiae on my legs. day 5 nausea with extreme pressure and fullness in the back of my neck. It felt like pressure on my head. No pain unless touch Only relief when sitting straight up. Took tylenol and ibuprofen and allegra but did have any relief. Telehealth with occupation heath.


New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=919179


Copyright © 2021 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166