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This is VAERS ID 1117742

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History of Changes from the VAERS Wayback Machine

First Appeared on 5/21/2021

VAERS ID: 1117742
VAERS Form:2
Age:36.0
Sex:Female
Location:Tennessee
Vaccinated:2021-03-18
Onset:2021-03-19
Submitted:0000-00-00
Entered:2021-03-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SC

Administered by: Pharmacy      Purchased by: ??
Symptoms: Abortion spontaneous, Injection site pain

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: Prentala vitamins
Current Illness: None
Preexisting Conditions: Psoriasis
Allergies: None
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pain at injection site starting one day after 2nd pregnancy (first was miscarriage), due date November 12

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