National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts.org
Search Results

This is VAERS ID 924690

Government Disclaimer on use of this data

History of Changes from the VAERS Wayback Machine

First Appeared on 1/22/2021

VAERS ID: 924690
VAERS Form:2
Age:38.0
Sex:Female
Location:North Carolina
Vaccinated:2021-01-05
Onset:2021-01-05
Submitted:0000-00-00
Entered:2021-01-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 039K20A / 1 LA / IM

Administered by: Public      Purchased by: ??
Symptoms: Body temperature increased, Chills, Injection site reaction, Pain, Musculoskeletal disorder, Joint range of motion decreased, Contusion, Impaired work ability, Inflammation

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? Yes
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Benadryl, vitamin d, vitamin b12
Current Illness: None
Preexisting Conditions: Pericardial effusion (fluid around heart) mostly resolved after surgery few months ago Year around allergies
Allergies: None
Diagnostic Lab Data: Dr visit at immediate care
CDC 'Split Type':

Write-up: Three to four hours after vaccine had bruising, major loss of range of motion, severe sharp pain, elevated temp and chills due to reaction of injection site Treatment given 24 hrs later- strong antibiotics, anti inflammatory, exercise, and three days out of work Due to loss of function of left arm due to inflammation


Changed on 5/7/2021

VAERS ID: 924690 Before After
VAERS Form:2
Age:38.0
Sex:Female
Location:North Carolina
Vaccinated:2021-01-05
Onset:2021-01-05
Submitted:0000-00-00
Entered:2021-01-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 039K20A / 1 LA / IM

Administered by: Public      Purchased by: ??
Symptoms: Body temperature increased, Chills, Injection site reaction, Pain, Musculoskeletal disorder, Joint range of motion decreased, Contusion, Impaired work ability, Inflammation

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? Yes
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Benadryl, vitamin d, vitamin b12
Current Illness: None
Preexisting Conditions: Pericardial effusion (fluid around heart) mostly resolved after surgery few months ago Year around allergies
Allergies: None None
Diagnostic Lab Data: Dr visit at immediate care
CDC 'Split Type':

Write-up: Three to four hours after vaccine had bruising, major loss of range of motion, severe sharp pain, elevated temp and chills due to reaction of injection site Treatment given 24 hrs later- strong antibiotics, anti inflammatory, exercise, and three days out of work Due to loss of function of left arm due to inflammation


Changed on 5/21/2021

VAERS ID: 924690 Before After
VAERS Form:2
Age:38.0
Sex:Female
Location:North Carolina
Vaccinated:2021-01-05
Onset:2021-01-05
Submitted:0000-00-00
Entered:2021-01-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 039K20A / 1 LA / IM

Administered by: Public      Purchased by: ??
Symptoms: Body temperature increased, Chills, Injection site reaction, Pain, Musculoskeletal disorder, Joint range of motion decreased, Contusion, Impaired work ability, Inflammation

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? Yes
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Benadryl, vitamin d, vitamin b12
Current Illness: None
Preexisting Conditions: Pericardial effusion (fluid around heart) mostly resolved after surgery few months ago Year around allergies
Allergies: None None
Diagnostic Lab Data: Dr visit at immediate care
CDC 'Split Type':

Write-up: Three to four hours after vaccine had bruising, major loss of range of motion, severe sharp pain, elevated temp and chills due to reaction of injection site Treatment given 24 hrs later- strong antibiotics, anti inflammatory, exercise, and three days out of work Due to loss of function of left arm due to inflammation

New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=924690&WAYBACKHISTORY=ON


Copyright © 2022 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166