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This is VAERS ID 933997

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History of Changes from the VAERS Wayback Machine

First Appeared on 3/19/2021

VAERS ID: 933997
VAERS Form:2
Age:33.0
Sex:Female
Location:Illinois
Vaccinated:2020-12-30
Onset:2021-01-05
Submitted:0000-00-00
Entered:2021-01-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 026L20A / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Injection site erythema, Injection site induration, Injection site pruritus, Petechiae, Injection site swelling

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:
Current Illness: None
Preexisting Conditions:
Allergies: Cardizem
Diagnostic Lab Data: CBC - normal
CDC 'Split Type':

Write-up: On 1/4 developed dime sized redness over vaccine site which on 1/5 enlarged with firmness, erythema and puritus. On 1/6 developed swelling to antecubital area which was gone by 1/7. On 1/7 developed erythema and petechiae to both upper arms.


Changed on 5/7/2021

VAERS ID: 933997 Before After
VAERS Form:2
Age:33.0
Sex:Female
Location:Illinois
Vaccinated:2020-12-30
Onset:2021-01-05
Submitted:0000-00-00
Entered:2021-01-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 026L20A / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Injection site erythema, Injection site induration, Injection site pruritus, Petechiae, Injection site swelling

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:
Current Illness: None
Preexisting Conditions:
Allergies: Cardizem Cardizem
Diagnostic Lab Data: CBC - normal
CDC 'Split Type':

Write-up: On 1/4 developed dime sized redness over vaccine site which on 1/5 enlarged with firmness, erythema and puritus. On 1/6 developed swelling to antecubital area which was gone by 1/7. On 1/7 developed erythema and petechiae to both upper arms.


Changed on 5/14/2021

VAERS ID: 933997 Before After
VAERS Form:2
Age:33.0
Sex:Female
Location:Illinois
Vaccinated:2020-12-30
Onset:2021-01-05
Submitted:0000-00-00
Entered:2021-01-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 026L20A / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Injection site erythema, Injection site induration, Injection site pruritus, Petechiae, Injection site swelling

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:
Current Illness: None
Preexisting Conditions:
Allergies: Cardizem Cardizem
Diagnostic Lab Data: CBC - normal
CDC 'Split Type':

Write-up: On 1/4 developed dime sized redness over vaccine site which on 1/5 enlarged with firmness, erythema and puritus. On 1/6 developed swelling to antecubital area which was gone by 1/7. On 1/7 developed erythema and petechiae to both upper arms.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=933997&WAYBACKHISTORY=ON


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