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This is VAERS ID 908010

History of Changes from the VAERS Wayback Machine

First Appeared on 4/1/2021

VAERS ID: 908010
VAERS Form:2
Age:37.0
Sex:Female
Location:Tennessee
Vaccinated:2020-12-23
Onset:2020-12-23
Submitted:0000-00-00
Entered:2020-12-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011J20A / 1 LA / SYR

Administered by: Public      Purchased by: ??
Symptoms: Feeling abnormal, Paraesthesia, Peripheral swelling, Facial discomfort

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: Metformin 500mg daily, fish oil daily, amlodipine 10mg daily, HCTZ 25mg daily, omeprazole 20mg daily, Tri-Lo-Sprintec daily, Cephalexin since Sunday 12/20/20 (spider bite on arm), hydrocortisone cream (for spider bite on arm)
Current Illness: Spider bite (treated in ER 12/20/20) treated with antibiotic and hydrocortisone cream
Preexisting Conditions: None
Allergies: Lisinopril
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient called clinic stating she has noticed slight tingling and slight swelling in legs since receiving her COVID-19 vaccine. She also states something "feels different" on the L side of her face. She overall doesn''t feel "normal." She is going to follow-up today with her PCP.


Changed on 5/7/2021

VAERS ID: 908010 Before After
VAERS Form:2
Age:37.0
Sex:Female
Location:Tennessee
Vaccinated:2020-12-23
Onset:2020-12-23
Submitted:0000-00-00
Entered:2020-12-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011J20A / 1 LA / SYR

Administered by: Public      Purchased by: ??
Symptoms: Feeling abnormal, Paraesthesia, Peripheral swelling, Facial discomfort

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: Metformin 500mg daily, fish oil daily, amlodipine 10mg daily, HCTZ 25mg daily, omeprazole 20mg daily, Tri-Lo-Sprintec daily, Cephalexin since Sunday 12/20/20 (spider bite on arm), hydrocortisone cream (for spider bite on arm)
Current Illness: Spider bite (treated in ER 12/20/20) treated with antibiotic and hydrocortisone cream
Preexisting Conditions: None
Allergies: Lisinopril Lisinopril
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient called clinic stating she has noticed slight tingling and slight swelling in legs since receiving her COVID-19 vaccine. She also states something "feels different" on the L side of her face. She overall doesn''t feel "normal." She is going to follow-up today with her PCP.


Changed on 5/14/2021

VAERS ID: 908010 Before After
VAERS Form:2
Age:37.0
Sex:Female
Location:Tennessee
Vaccinated:2020-12-23
Onset:2020-12-23
Submitted:0000-00-00
Entered:2020-12-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011J20A / 1 LA / SYR

Administered by: Public      Purchased by: ??
Symptoms: Feeling abnormal, Paraesthesia, Peripheral swelling, Facial discomfort

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: Metformin 500mg daily, fish oil daily, amlodipine 10mg daily, HCTZ 25mg daily, omeprazole 20mg daily, Tri-Lo-Sprintec daily, Cephalexin since Sunday 12/20/20 (spider bite on arm), hydrocortisone cream (for spider bite on arm)
Current Illness: Spider bite (treated in ER 12/20/20) treated with antibiotic and hydrocortisone cream
Preexisting Conditions: None
Allergies: Lisinopril Lisinopril
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient called clinic stating she has noticed slight tingling and slight swelling in legs since receiving her COVID-19 vaccine. She also states something "feels different" on the L side of her face. She overall doesn''t feel "normal." She is going to follow-up today with her PCP.

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https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=908010&WAYBACKHISTORY=ON


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