National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 926619

History of Changes from the VAERS Wayback Machine

First Appeared on 3/11/2021

VAERS ID: 926619
VAERS Form:2
Age:47.0
Sex:Female
Location:Texas
Vaccinated:2021-01-07
Onset:2021-01-07
Submitted:0000-00-00
Entered:2021-01-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025L20A / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Petechiae, Pruritus, Rash, Rash erythematous, Sensory disturbance, Limb discomfort, Lip pruritus

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? No
Previous Vaccinations:
Other Medications: Progesterone
Current Illness: None
Preexisting Conditions: lactose-intolerance, hormone imbalance, vitamin D deficiency
Allergies: cucumber, water melon, bell pepper, strawberries, etc.
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: Approximately 5 minutes after receiving vaccine, patient experienced itching on upper lip and itching on left upper arm. Appears to have a petechial rash with redness on left upper arm. Itching is stable and not getting worse. Left arm feels a little heavy with some unusual sensation. Initial BP 155/91 HR=80. O2=98%. Repeat BP 137/90 HR=77 O2=97%. Patient declined Benadryl because the symptoms are stable and patient did not want to get sleepy from the Benadryl and patient wanted to return to work. Patient clinically stable. Patient released at 10:15am.


Changed on 5/7/2021

VAERS ID: 926619 Before After
VAERS Form:2
Age:47.0
Sex:Female
Location:Texas
Vaccinated:2021-01-07
Onset:2021-01-07
Submitted:0000-00-00
Entered:2021-01-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025L20A / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Petechiae, Pruritus, Rash, Rash erythematous, Sensory disturbance, Limb discomfort, Lip pruritus

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? No
Previous Vaccinations:
Other Medications: Progesterone
Current Illness: None
Preexisting Conditions: lactose-intolerance, hormone imbalance, vitamin D deficiency
Allergies: cucumber, water melon, bell pepper, strawberries, etc. etc.
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: Approximately 5 minutes after receiving vaccine, patient experienced itching on upper lip and itching on left upper arm. Appears to have a petechial rash with redness on left upper arm. Itching is stable and not getting worse. Left arm feels a little heavy with some unusual sensation. Initial BP 155/91 HR=80. O2=98%. Repeat BP 137/90 HR=77 O2=97%. Patient declined Benadryl because the symptoms are stable and patient did not want to get sleepy from the Benadryl and patient wanted to return to work. Patient clinically stable. Patient released at 10:15am.


Changed on 5/14/2021

VAERS ID: 926619 Before After
VAERS Form:2
Age:47.0
Sex:Female
Location:Texas
Vaccinated:2021-01-07
Onset:2021-01-07
Submitted:0000-00-00
Entered:2021-01-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025L20A / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Petechiae, Pruritus, Rash, Rash erythematous, Sensory disturbance, Limb discomfort, Lip pruritus

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? No
Previous Vaccinations:
Other Medications: Progesterone
Current Illness: None
Preexisting Conditions: lactose-intolerance, hormone imbalance, vitamin D deficiency
Allergies: cucumber, water melon, bell pepper, strawberries, etc. etc.
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: Approximately 5 minutes after receiving vaccine, patient experienced itching on upper lip and itching on left upper arm. Appears to have a petechial rash with redness on left upper arm. Itching is stable and not getting worse. Left arm feels a little heavy with some unusual sensation. Initial BP 155/91 HR=80. O2=98%. Repeat BP 137/90 HR=77 O2=97%. Patient declined Benadryl because the symptoms are stable and patient did not want to get sleepy from the Benadryl and patient wanted to return to work. Patient clinically stable. Patient released at 10:15am.

New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=926619&WAYBACKHISTORY=ON


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