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This is VAERS ID 930278

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History of Changes from the VAERS Wayback Machine

First Appeared on 3/19/2021

VAERS ID: 930278
VAERS Form:2
Age:14.0
Sex:Female
Location:Alabama
Vaccinated:2020-12-29
Onset:2020-12-29
Submitted:0000-00-00
Entered:2021-01-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037K20A / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: No adverse event, Product administered to patient of inappropriate age

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: Lamictal, Keppra, folic acid
Current Illness: none
Preexisting Conditions: epilepsy
Allergies: none
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient is 14 years old, and the vaccine is not indicated for patients under the age of 18. We have been checking in with the patient and the patient has not experienced any signs or symptoms of any adverse event.


Changed on 5/7/2021

VAERS ID: 930278 Before After
VAERS Form:2
Age:14.0
Sex:Female
Location:Alabama
Vaccinated:2020-12-29
Onset:2020-12-29
Submitted:0000-00-00
Entered:2021-01-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037K20A / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: No adverse event, Product administered to patient of inappropriate age

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: Lamictal, Keppra, folic acid
Current Illness: none
Preexisting Conditions: epilepsy
Allergies: none none
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient is 14 years old, and the vaccine is not indicated for patients under the age of 18. We have been checking in with the patient and the patient has not experienced any signs or symptoms of any adverse event.


Changed on 5/21/2021

VAERS ID: 930278 Before After
VAERS Form:2
Age:14.0
Sex:Female
Location:Alabama
Vaccinated:2020-12-29
Onset:2020-12-29
Submitted:0000-00-00
Entered:2021-01-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037K20A / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: No adverse event, Product administered to patient of inappropriate age

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: Lamictal, Keppra, folic acid
Current Illness: none
Preexisting Conditions: epilepsy
Allergies: none none
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient is 14 years old, and the vaccine is not indicated for patients under the age of 18. We have been checking in with the patient and the patient has not experienced any signs or symptoms of any adverse event.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=930278&WAYBACKHISTORY=ON


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