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This is VAERS ID 916065

History of Changes from the VAERS Wayback Machine

First Appeared on 1/7/2021

VAERS ID: 916065
VAERS Form:2
Age:37.0
Sex:Female
Location:Washington
Vaccinated:2020-12-27
Onset:2020-12-28
Submitted:0000-00-00
Entered:2020-12-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037K20A / 1 LA / SYR

Administered by: Other      Purchased by: ??
Symptoms: Hydrops foetalis, Premature labour, Foetal monitoring, Exposure during pregnancy

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Zofran 2weeks prior, Multivatamins
Current Illness: none
Preexisting Conditions:
Allergies: Sulfa, Vicodin, Neosporin
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: EDD - 4/1/2021 - Contractions at 26 w 3 days sent to L&D to be monitored on 12/28/20. Covid-19 Sars Vaccine given 1st dose 12/27/20. Patient was diagnosed with Fetal Hydrops. Patient Hospitalized 12/28/20 - current MFM consulting in hospital & outpatient


Changed on 5/7/2021

VAERS ID: 916065 Before After
VAERS Form:2
Age:37.0
Sex:Female
Location:Washington
Vaccinated:2020-12-27
Onset:2020-12-28
Submitted:0000-00-00
Entered:2020-12-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037K20A / 1 LA / SYR

Administered by: Other      Purchased by: ??
Symptoms: Hydrops foetalis, Premature labour, Foetal monitoring, Exposure during pregnancy

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Zofran 2weeks prior, Multivatamins
Current Illness: none
Preexisting Conditions:
Allergies: Sulfa, Vicodin, Neosporin Neosporin
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: EDD - 4/1/2021 - Contractions at 26 w 3 days sent to L&D to be monitored on 12/28/20. Covid-19 Sars Vaccine given 1st dose 12/27/20. Patient was diagnosed with Fetal Hydrops. Patient Hospitalized 12/28/20 - current MFM consulting in hospital & outpatient


Changed on 5/14/2021

VAERS ID: 916065 Before After
VAERS Form:2
Age:37.0
Sex:Female
Location:Washington
Vaccinated:2020-12-27
Onset:2020-12-28
Submitted:0000-00-00
Entered:2020-12-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037K20A / 1 LA / SYR

Administered by: Other      Purchased by: ??
Symptoms: Hydrops foetalis, Premature labour, Foetal monitoring, Exposure during pregnancy

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Zofran 2weeks prior, Multivatamins
Current Illness: none
Preexisting Conditions:
Allergies: Sulfa, Vicodin, Neosporin Neosporin
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: EDD - 4/1/2021 - Contractions at 26 w 3 days sent to L&D to be monitored on 12/28/20. Covid-19 Sars Vaccine given 1st dose 12/27/20. Patient was diagnosed with Fetal Hydrops. Patient Hospitalized 12/28/20 - current MFM consulting in hospital & outpatient

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https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=916065&WAYBACKHISTORY=ON


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