National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts.org
Search Results

This is VAERS ID 934387

Government Disclaimer on use of this data

History of Changes from the VAERS Wayback Machine

First Appeared on 3/19/2021

VAERS ID: 934387
VAERS Form:2
Age:17.0
Sex:Male
Location:Nebraska
Vaccinated:2020-12-23
Onset:2020-12-23
Submitted:0000-00-00
Entered:2021-01-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025J20-2A / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Pain in extremity

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: sore arm
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: Penicillin
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: slight sore arm


Changed on 5/7/2021

VAERS ID: 934387 Before After
VAERS Form:2
Age:17.0
Sex:Male
Location:Nebraska
Vaccinated:2020-12-23
Onset:2020-12-23
Submitted:0000-00-00
Entered:2021-01-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025J20-2A / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Pain in extremity

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: sore arm
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: Penicillin Penicillin
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: slight sore arm


Changed on 5/21/2021

VAERS ID: 934387 Before After
VAERS Form:2
Age:17.0
Sex:Male
Location:Nebraska
Vaccinated:2020-12-23
Onset:2020-12-23
Submitted:0000-00-00
Entered:2021-01-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025J20-2A / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Pain in extremity

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: sore arm
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: Penicillin Penicillin
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: slight sore arm

New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=934387&WAYBACKHISTORY=ON


Copyright © 2022 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166