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This is VAERS ID 924539

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History of Changes from the VAERS Wayback Machine

First Appeared on 1/22/2021

VAERS ID: 924539
VAERS Form:2
Age:40.0
Sex:Female
Location:California
Vaccinated:2021-01-06
Onset:2021-01-06
Submitted:0000-00-00
Entered:2021-01-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037K20A / UNK LA / IM

Administered by: Public      Purchased by: ??
Symptoms: Dizziness, Flushing, Nausea, Retching, Throat tightness, Blood test, Oropharyngeal pain

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)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Albuterol Inhaler, Nortriptyline, baclofen
Current Illness: none
Preexisting Conditions: osteio arthritis, joint hyper mobility, chronic migrans, fibromyalgia, IBS,
Allergies: Penicillin and mushrooms, and nsaid.
Diagnostic Lab Data: 01/06/21-Blood panels and vital signs.
CDC 'Split Type':

Write-up: At 10:12 am, Client c/o of sore throat, tightness in throat that relieve quickly, nausea, dry heaves, flushed, light headed and dizziness. Called for EMT. They arrive at 10:25 am and transported her to the local hospital for observation. 01/06/21-Treatment in hospital blood draw, medications given Zofran, Decadron, Benadryl, and Pepcid, and IV fluids. Discharged home at 1244.


Changed on 5/7/2021

VAERS ID: 924539 Before After
VAERS Form:2
Age:40.0
Sex:Female
Location:California
Vaccinated:2021-01-06
Onset:2021-01-06
Submitted:0000-00-00
Entered:2021-01-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037K20A / UNK LA / IM

Administered by: Public      Purchased by: ??
Symptoms: Dizziness, Flushing, Nausea, Retching, Throat tightness, Blood test, Oropharyngeal pain

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)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Albuterol Inhaler, Nortriptyline, baclofen
Current Illness: none
Preexisting Conditions: osteio arthritis, joint hyper mobility, chronic migrans, fibromyalgia, IBS,
Allergies: Penicillin and mushrooms, and nsaid. nsaid.
Diagnostic Lab Data: 01/06/21-Blood panels and vital signs.
CDC 'Split Type':

Write-up: At 10:12 am, Client c/o of sore throat, tightness in throat that relieve quickly, nausea, dry heaves, flushed, light headed and dizziness. Called for EMT. They arrive at 10:25 am and transported her to the local hospital for observation. 01/06/21-Treatment in hospital blood draw, medications given Zofran, Decadron, Benadryl, and Pepcid, and IV fluids. Discharged home at 1244.


Changed on 5/21/2021

VAERS ID: 924539 Before After
VAERS Form:2
Age:40.0
Sex:Female
Location:California
Vaccinated:2021-01-06
Onset:2021-01-06
Submitted:0000-00-00
Entered:2021-01-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037K20A / UNK LA / IM

Administered by: Public      Purchased by: ??
Symptoms: Dizziness, Flushing, Nausea, Retching, Throat tightness, Blood test, Oropharyngeal pain

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)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Albuterol Inhaler, Nortriptyline, baclofen
Current Illness: none
Preexisting Conditions: osteio arthritis, joint hyper mobility, chronic migrans, fibromyalgia, IBS,
Allergies: Penicillin and mushrooms, and nsaid. nsaid.
Diagnostic Lab Data: 01/06/21-Blood panels and vital signs.
CDC 'Split Type':

Write-up: At 10:12 am, Client c/o of sore throat, tightness in throat that relieve quickly, nausea, dry heaves, flushed, light headed and dizziness. Called for EMT. They arrive at 10:25 am and transported her to the local hospital for observation. 01/06/21-Treatment in hospital blood draw, medications given Zofran, Decadron, Benadryl, and Pepcid, and IV fluids. Discharged home at 1244.

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