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This is VAERS ID 935404

History of Changes from the VAERS Wayback Machine

First Appeared on 3/26/2021

VAERS ID: 935404
VAERS Form:2
Age:62.0
Sex:Female
Location:California
Vaccinated:2021-01-07
Onset:2021-01-09
Submitted:0000-00-00
Entered:2021-01-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025L20A / 1 LA / IM

Administered by: Work      Purchased by: ??
Symptoms: Discomfort, Injection site pain, Nausea, Petechiae, Pruritus, Rash, Rash erythematous

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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Per individual, received dose 1 of Moderna Vaccine on 1/7/21 at workplace clinic. ''Over weekend'' experienced a ''body rash'' (fine red points/petechiae)that encompassed trunk area of body and became increasingly uncomfortable along with sense of nausea and continuous sore arm at site of injection. Patient states use of benadryl has helped with the discomfort of the rash however when medication wears off, itching begins again. Denies any respiratory affects requiring emergency intervention at this time. Patient able to perform duties at workplace. Patient was instructed to talk with the Employee Health Nurse regarding situation.


Changed on 5/7/2021

VAERS ID: 935404 Before After
VAERS Form:2
Age:62.0
Sex:Female
Location:California
Vaccinated:2021-01-07
Onset:2021-01-09
Submitted:0000-00-00
Entered:2021-01-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025L20A / 1 LA / IM

Administered by: Work      Purchased by: ??
Symptoms: Discomfort, Injection site pain, Nausea, Petechiae, Pruritus, Rash, Rash erythematous

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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Per individual, received dose 1 of Moderna Vaccine on 1/7/21 at workplace clinic. ''Over weekend'' experienced a ''body rash'' (fine red points/petechiae)that encompassed trunk area of body and became increasingly uncomfortable along with sense of nausea and continuous sore arm at site of injection. Patient states use of benadryl has helped with the discomfort of the rash however when medication wears off, itching begins again. Denies any respiratory affects requiring emergency intervention at this time. Patient able to perform duties at workplace. Patient was instructed to talk with the Employee Health Nurse regarding situation.


Changed on 5/14/2021

VAERS ID: 935404 Before After
VAERS Form:2
Age:62.0
Sex:Female
Location:California
Vaccinated:2021-01-07
Onset:2021-01-09
Submitted:0000-00-00
Entered:2021-01-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025L20A / 1 LA / IM

Administered by: Work      Purchased by: ??
Symptoms: Discomfort, Injection site pain, Nausea, Petechiae, Pruritus, Rash, Rash erythematous

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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Per individual, received dose 1 of Moderna Vaccine on 1/7/21 at workplace clinic. ''Over weekend'' experienced a ''body rash'' (fine red points/petechiae)that encompassed trunk area of body and became increasingly uncomfortable along with sense of nausea and continuous sore arm at site of injection. Patient states use of benadryl has helped with the discomfort of the rash however when medication wears off, itching begins again. Denies any respiratory affects requiring emergency intervention at this time. Patient able to perform duties at workplace. Patient was instructed to talk with the Employee Health Nurse regarding situation.

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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=935404&WAYBACKHISTORY=ON

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