National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts.org
Search Results

From the 1/14/2022 release of VAERS data:

This is VAERS ID 926027

Government Disclaimer on use of this data



Case Details

VAERS ID: 926027 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: Connecticut  
Vaccinated:2020-12-29
Onset:2020-12-30
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-01-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011J20A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain, Decreased appetite, Headache, Injection site erythema, Injection site swelling, Lymphadenopathy, Nausea
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin D 2000 cu fluticasone propionate 50 mcg cetirizine hydrochloride 10 mg lo loestrin FE 1-10
Current Illness: none
Preexisting Conditions: none
Allergies: Augmentin
Diagnostic Lab Data: no tests as of yet
CDC Split Type:

Write-up: Begin with abdominal pain on December 30 when she woke up, continued with nausea, then headaches, loss of appetite and by Sunday January 3, 2021 swollen lymph node in left arm pit. Was seen on January 4, 2021, told to call or return if it gets worse. As of today she still has a swollen lymph node and swelling and redness around her injection site.


New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=926027


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