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This is VAERS ID 919624

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History of Changes from the VAERS Wayback Machine

First Appeared on 1/7/2021

VAERS ID: 919624
VAERS Form:2
Age:29.0
Sex:Female
Location:Pennsylvania
Vaccinated:2020-12-29
Onset:2020-12-29
Submitted:0000-00-00
Entered:2021-01-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011J20A / 1 LA / IM

Administered by: Work      Purchased by: ??
Symptoms: Asthenia, Blood pressure decreased, Chills, Dizziness, Fatigue, Headache, Lymphadenopathy, Nausea, Pain in extremity, Paraesthesia, Speech disorder, Syncope, Mobility decreased, Hot flush, Decreased appetite

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:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: no
Current Illness: no
Preexisting Conditions: no
Allergies: Penicillin
Diagnostic Lab Data: no
CDC 'Split Type':

Write-up: Around 10 or 11 pm, arm pain, chills, fatigue, headache, nausea, swollen lymph nodes, lightheadedness, fainted in tub. Next day, fatigue all day, couldn''t talk, or eat. Went back to bed again. The following day hot flashes, weakness. went to ER. Felt like blood pressure was dropping, tingling in legs, difficulty lifting her head.


Changed on 5/7/2021

VAERS ID: 919624 Before After
VAERS Form:2
Age:29.0
Sex:Female
Location:Pennsylvania
Vaccinated:2020-12-29
Onset:2020-12-29
Submitted:0000-00-00
Entered:2021-01-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011J20A / 1 LA / IM

Administered by: Work      Purchased by: ??
Symptoms: Asthenia, Blood pressure decreased, Chills, Dizziness, Fatigue, Headache, Lymphadenopathy, Nausea, Pain in extremity, Paraesthesia, Speech disorder, Syncope, Mobility decreased, Hot flush, Decreased appetite

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:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: no
Current Illness: no
Preexisting Conditions: no
Allergies: Penicillin Penicillin
Diagnostic Lab Data: no
CDC 'Split Type':

Write-up: Around 10 or 11 pm, arm pain, chills, fatigue, headache, nausea, swollen lymph nodes, lightheadedness, fainted in tub. Next day, fatigue all day, couldn''t talk, or eat. Went back to bed again. The following day hot flashes, weakness. went to ER. Felt like blood pressure was dropping, tingling in legs, difficulty lifting her head.


Changed on 5/14/2021

VAERS ID: 919624 Before After
VAERS Form:2
Age:29.0
Sex:Female
Location:Pennsylvania
Vaccinated:2020-12-29
Onset:2020-12-29
Submitted:0000-00-00
Entered:2021-01-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011J20A / 1 LA / IM

Administered by: Work      Purchased by: ??
Symptoms: Asthenia, Blood pressure decreased, Chills, Dizziness, Fatigue, Headache, Lymphadenopathy, Nausea, Pain in extremity, Paraesthesia, Speech disorder, Syncope, Mobility decreased, Hot flush, Decreased appetite

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:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: no
Current Illness: no
Preexisting Conditions: no
Allergies: Penicillin Penicillin
Diagnostic Lab Data: no
CDC 'Split Type':

Write-up: Around 10 or 11 pm, arm pain, chills, fatigue, headache, nausea, swollen lymph nodes, lightheadedness, fainted in tub. Next day, fatigue all day, couldn''t talk, or eat. Went back to bed again. The following day hot flashes, weakness. went to ER. Felt like blood pressure was dropping, tingling in legs, difficulty lifting her head.

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