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This is VAERS ID 930014

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History of Changes from the VAERS Wayback Machine

First Appeared on 3/19/2021

VAERS ID: 930014
VAERS Form:2
Age:19.0
Sex:Male
Location:Connecticut
Vaccinated:2021-01-06
Onset:2021-01-07
Submitted:0000-00-00
Entered:2021-01-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 026L20A / 1 LA / SYR

Administered by: Public      Purchased by: ??
Symptoms: Influenza like illness, Rhinorrhoea, Oropharyngeal pain, COVID-19, SARS-CoV-2 test positive

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: None
Current Illness: None
Preexisting Conditions: None
Allergies: Penicillins
Diagnostic Lab Data: Positive COVID Test: 1:46pm 1/8/2021
CDC 'Split Type':

Write-up: Tested Positive for COVID 19 No prior symptoms or known exposures Flu Like Symptoms occurred Day after Running nose 2 days after Sore Throat


Changed on 5/7/2021

VAERS ID: 930014 Before After
VAERS Form:2
Age:19.0
Sex:Male
Location:Connecticut
Vaccinated:2021-01-06
Onset:2021-01-07
Submitted:0000-00-00
Entered:2021-01-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 026L20A / 1 LA / SYR

Administered by: Public      Purchased by: ??
Symptoms: Influenza like illness, Rhinorrhoea, Oropharyngeal pain, COVID-19, SARS-CoV-2 test positive

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: None
Current Illness: None
Preexisting Conditions: None
Allergies: Penicillins Penicillins
Diagnostic Lab Data: Positive COVID Test: 1:46pm 1/8/2021
CDC 'Split Type':

Write-up: Tested Positive for COVID 19 No prior symptoms or known exposures Flu Like Symptoms occurred Day after Running nose 2 days after Sore Throat


Changed on 5/21/2021

VAERS ID: 930014 Before After
VAERS Form:2
Age:19.0
Sex:Male
Location:Connecticut
Vaccinated:2021-01-06
Onset:2021-01-07
Submitted:0000-00-00
Entered:2021-01-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 026L20A / 1 LA / SYR

Administered by: Public      Purchased by: ??
Symptoms: Influenza like illness, Rhinorrhoea, Oropharyngeal pain, COVID-19, SARS-CoV-2 test positive

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: None
Current Illness: None
Preexisting Conditions: None
Allergies: Penicillins Penicillins
Diagnostic Lab Data: Positive COVID Test: 1:46pm 1/8/2021
CDC 'Split Type':

Write-up: Tested Positive for COVID 19 No prior symptoms or known exposures Flu Like Symptoms occurred Day after Running nose 2 days after Sore Throat

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=930014&WAYBACKHISTORY=ON


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