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This is VAERS ID 937172

History of Changes from the VAERS Wayback Machine

First Appeared on 3/26/2021

VAERS ID: 937172
VAERS Form:2
Age:52.0
Sex:Female
Location:Texas
Vaccinated:2020-12-30
Onset:2021-01-09
Submitted:0000-00-00
Entered:2021-01-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025L20A / 1 OT / IM

Administered by: Private      Purchased by: ??
Symptoms: Injection site bruising, Injection site induration, Injection site paraesthesia, Injection site pruritus, Injection site warmth, Petechiae, Injection site nodule

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:
Other Medications: Estrogen 2mg PO q am Progesterone 400mg PO q hs Propranolol 60mg PO PO BID VItamin D3 5,000IU PO q am Pantoprazole 40mg PO q am Atorvastatin 10mg PO q every other hs Cyclobenzaprine 5mg PO q hs Celecoxib 200mg PO q am
Current Illness: None
Preexisting Conditions: Essential tremor Menopausal state Osteoarthritis bilateral knees GERD Pinched nerve in neck
Allergies: Morphine Shellfish
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: 10 days after the date of vaccination, the injection site to the right gluteal region became hot, itchy, and started to tingle. Petechiae noted approximately 2-2.5 inches all around injection site. Large, firm "knot" developed under the area. On day 12 following the injection, the petechiae faded and left a large bruise over the area. The large, firm "knot" area started to decrease.


Changed on 5/7/2021

VAERS ID: 937172 Before After
VAERS Form:2
Age:52.0
Sex:Female
Location:Texas
Vaccinated:2020-12-30
Onset:2021-01-09
Submitted:0000-00-00
Entered:2021-01-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025L20A / 1 OT / IM

Administered by: Private      Purchased by: ??
Symptoms: Injection site bruising, Injection site induration, Injection site paraesthesia, Injection site pruritus, Injection site warmth, Petechiae, Injection site nodule

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:
Other Medications: Estrogen 2mg PO q am Progesterone 400mg PO q hs Propranolol 60mg PO PO BID VItamin D3 5,000IU PO q am Pantoprazole 40mg PO q am Atorvastatin 10mg PO q every other hs Cyclobenzaprine 5mg PO q hs Celecoxib 200mg PO q am
Current Illness: None
Preexisting Conditions: Essential tremor Menopausal state Osteoarthritis bilateral knees GERD Pinched nerve in neck
Allergies: Morphine Shellfish Shellfish
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: 10 days after the date of vaccination, the injection site to the right gluteal region became hot, itchy, and started to tingle. Petechiae noted approximately 2-2.5 inches all around injection site. Large, firm "knot" developed under the area. On day 12 following the injection, the petechiae faded and left a large bruise over the area. The large, firm "knot" area started to decrease.


Changed on 5/14/2021

VAERS ID: 937172 Before After
VAERS Form:2
Age:52.0
Sex:Female
Location:Texas
Vaccinated:2020-12-30
Onset:2021-01-09
Submitted:0000-00-00
Entered:2021-01-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025L20A / 1 OT / IM

Administered by: Private      Purchased by: ??
Symptoms: Injection site bruising, Injection site induration, Injection site paraesthesia, Injection site pruritus, Injection site warmth, Petechiae, Injection site nodule

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:
Other Medications: Estrogen 2mg PO q am Progesterone 400mg PO q hs Propranolol 60mg PO PO BID VItamin D3 5,000IU PO q am Pantoprazole 40mg PO q am Atorvastatin 10mg PO q every other hs Cyclobenzaprine 5mg PO q hs Celecoxib 200mg PO q am
Current Illness: None
Preexisting Conditions: Essential tremor Menopausal state Osteoarthritis bilateral knees GERD Pinched nerve in neck
Allergies: Morphine Shellfish Shellfish
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: 10 days after the date of vaccination, the injection site to the right gluteal region became hot, itchy, and started to tingle. Petechiae noted approximately 2-2.5 inches all around injection site. Large, firm "knot" developed under the area. On day 12 following the injection, the petechiae faded and left a large bruise over the area. The large, firm "knot" area started to decrease.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=937172&WAYBACKHISTORY=ON

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