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This is VAERS ID 988042

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History of Changes from the VAERS Wayback Machine

First Appeared on 4/23/2021

VAERS ID: 988042
VAERS Form:2
Age:17.0
Sex:Female
Location:Oklahoma
Vaccinated:2021-01-18
Onset:2021-01-23
Submitted:0000-00-00
Entered:2021-01-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

Administered by: Public      Purchased by: ??
Symptoms: Dermatitis atopic, Pain, Rash, Rash pruritic, SARS-CoV-2 test negative

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: triamcinolone acetonide (KENALOG) 0.5 % Cream levocetirizine (Xyzal) 5 mg tablet clobetasoL (TEMOVATE) 0.05 % Cream Eucrisa 2 % Ointment mupirocin (BACTROBAN) 2 % Ointment ASHLYNA 0.15 mg-30 mcg (84)/10 mcg (7) Tablet, Dose Pack, 3 Months a
Current Illness:
Preexisting Conditions: Eczema, Autism, OCD, Depression, Overweight
Allergies: Benadryl, Robitussin
Diagnostic Lab Data: She had a negative COVID PCR test 5 days post vaccine.
CDC 'Split Type':

Write-up: Starting 5 days after her 1st Moderna COVID vaccine, she started to break out in a pruritic migratory rash, abdomen, trunk, arms, feet, face, comes and goes, migratory, looks consistent with known atopic dermatitis, worsening after the vaccine with nothing else new introduced. She also had body aches and viral symptoms 5 days post-vaccine. The rash is still present 11 days post vaccine.


Changed on 5/7/2021

VAERS ID: 988042 Before After
VAERS Form:2
Age:17.0
Sex:Female
Location:Oklahoma
Vaccinated:2021-01-18
Onset:2021-01-23
Submitted:0000-00-00
Entered:2021-01-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

Administered by: Public      Purchased by: ??
Symptoms: Dermatitis atopic, Pain, Rash, Rash pruritic, SARS-CoV-2 test negative

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: triamcinolone acetonide (KENALOG) 0.5 % Cream levocetirizine (Xyzal) 5 mg tablet clobetasoL (TEMOVATE) 0.05 % Cream Eucrisa 2 % Ointment mupirocin (BACTROBAN) 2 % Ointment ASHLYNA 0.15 mg-30 mcg (84)/10 mcg (7) Tablet, Dose Pack, 3 Months a
Current Illness:
Preexisting Conditions: Eczema, Autism, OCD, Depression, Overweight
Allergies: Benadryl, Robitussin Robitussin
Diagnostic Lab Data: She had a negative COVID PCR test 5 days post vaccine.
CDC 'Split Type':

Write-up: Starting 5 days after her 1st Moderna COVID vaccine, she started to break out in a pruritic migratory rash, abdomen, trunk, arms, feet, face, comes and goes, migratory, looks consistent with known atopic dermatitis, worsening after the vaccine with nothing else new introduced. She also had body aches and viral symptoms 5 days post-vaccine. The rash is still present 11 days post vaccine.


Changed on 5/14/2021

VAERS ID: 988042 Before After
VAERS Form:2
Age:17.0
Sex:Female
Location:Oklahoma
Vaccinated:2021-01-18
Onset:2021-01-23
Submitted:0000-00-00
Entered:2021-01-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

Administered by: Public      Purchased by: ??
Symptoms: Dermatitis atopic, Pain, Rash, Rash pruritic, SARS-CoV-2 test negative

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: triamcinolone acetonide (KENALOG) 0.5 % Cream levocetirizine (Xyzal) 5 mg tablet clobetasoL (TEMOVATE) 0.05 % Cream Eucrisa 2 % Ointment mupirocin (BACTROBAN) 2 % Ointment ASHLYNA 0.15 mg-30 mcg (84)/10 mcg (7) Tablet, Dose Pack, 3 Months a
Current Illness:
Preexisting Conditions: Eczema, Autism, OCD, Depression, Overweight
Allergies: Benadryl, Robitussin Robitussin
Diagnostic Lab Data: She had a negative COVID PCR test 5 days post vaccine.
CDC 'Split Type':

Write-up: Starting 5 days after her 1st Moderna COVID vaccine, she started to break out in a pruritic migratory rash, abdomen, trunk, arms, feet, face, comes and goes, migratory, looks consistent with known atopic dermatitis, worsening after the vaccine with nothing else new introduced. She also had body aches and viral symptoms 5 days post-vaccine. The rash is still present 11 days post vaccine.

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