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This is VAERS ID 927069

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History of Changes from the VAERS Wayback Machine

First Appeared on 3/19/2021

VAERS ID: 927069
VAERS Form:2
Age:19.0
Sex:Female
Location:Utah
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 011L20A / 1 LA / IM

Administered by: Work      Purchased by: ??
Symptoms: Cold sweat, Dizziness, Nausea, Pain in extremity, Pharyngeal hypoaesthesia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Clammy, dizzy, nauseas, left arm pain and numb throat. She was monitored on exam table and she rested and was given Benadryl and Claritin and started to feel better by 45-60 minutes. By 2 hours she was completely normal and cleared to leave.


Changed on 5/7/2021

VAERS ID: 927069 Before After
VAERS Form:2
Age:19.0
Sex:Female
Location:Utah
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 011L20A / 1 LA / IM

Administered by: Work      Purchased by: ??
Symptoms: Cold sweat, Dizziness, Nausea, Pain in extremity, Pharyngeal hypoaesthesia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: none
Current Illness: none
Preexisting Conditions: none
Allergies: none none
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Clammy, dizzy, nauseas, left arm pain and numb throat. She was monitored on exam table and she rested and was given Benadryl and Claritin and started to feel better by 45-60 minutes. By 2 hours she was completely normal and cleared to leave.


Changed on 5/21/2021

VAERS ID: 927069 Before After
VAERS Form:2
Age:19.0
Sex:Female
Location:Utah
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 011L20A / 1 LA / IM

Administered by: Work      Purchased by: ??
Symptoms: Cold sweat, Dizziness, Nausea, Pain in extremity, Pharyngeal hypoaesthesia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: none
Current Illness: none
Preexisting Conditions: none
Allergies: none none
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Clammy, dizzy, nauseas, left arm pain and numb throat. She was monitored on exam table and she rested and was given Benadryl and Claritin and started to feel better by 45-60 minutes. By 2 hours she was completely normal and cleared to leave.

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