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This is VAERS ID 932887

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History of Changes from the VAERS Wayback Machine

First Appeared on 3/19/2021

VAERS ID: 932887
VAERS Form:2
Age:19.0
Sex:Female
Location:North Carolina
Vaccinated:2021-01-10
Onset:2021-01-10
Submitted:0000-00-00
Entered:2021-01-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 012L20A / 1 LA / SYR

Administered by: Senior Living      Purchased by: ??
Symptoms: Body temperature increased, Pain, Rash

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: n/a
Current Illness: n/a
Preexisting Conditions: None listed
Allergies: None listed on consent form
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient states "hurting all over." Temperature went from 98 degrees to 99 degrees. Her blood pressure was normal when checked twice. Three hours later she started having a rash around neck. Multiple times we asked her if her lips or throat was swelling. She said no. She went to urgent care-they sent her home with advice to take Benadryl or APAP.


Changed on 5/7/2021

VAERS ID: 932887 Before After
VAERS Form:2
Age:19.0
Sex:Female
Location:North Carolina
Vaccinated:2021-01-10
Onset:2021-01-10
Submitted:0000-00-00
Entered:2021-01-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 012L20A / 1 LA / SYR

Administered by: Senior Living      Purchased by: ??
Symptoms: Body temperature increased, Pain, Rash

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: n/a
Current Illness: n/a
Preexisting Conditions: None listed
Allergies: None listed on consent form form
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient states "hurting all over." Temperature went from 98 degrees to 99 degrees. Her blood pressure was normal when checked twice. Three hours later she started having a rash around neck. Multiple times we asked her if her lips or throat was swelling. She said no. She went to urgent care-they sent her home with advice to take Benadryl or APAP.


Changed on 5/21/2021

VAERS ID: 932887 Before After
VAERS Form:2
Age:19.0
Sex:Female
Location:North Carolina
Vaccinated:2021-01-10
Onset:2021-01-10
Submitted:0000-00-00
Entered:2021-01-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 012L20A / 1 LA / SYR

Administered by: Senior Living      Purchased by: ??
Symptoms: Body temperature increased, Pain, Rash

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: n/a
Current Illness: n/a
Preexisting Conditions: None listed
Allergies: None listed on consent form form
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient states "hurting all over." Temperature went from 98 degrees to 99 degrees. Her blood pressure was normal when checked twice. Three hours later she started having a rash around neck. Multiple times we asked her if her lips or throat was swelling. She said no. She went to urgent care-they sent her home with advice to take Benadryl or APAP.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=932887&WAYBACKHISTORY=ON


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