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This is VAERS ID 916428

History of Changes from the VAERS Wayback Machine

First Appeared on 2/12/2021

VAERS ID: 916428
VAERS Form:2
Age:16.0
Sex:Female
Location:Texas
Vaccinated:2020-12-30
Onset:2020-12-30
Submitted:0000-00-00
Entered:2020-12-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037K20A / 1 LA / IM

Administered by: Public      Purchased by: ??
Symptoms: Pruritus, Urticaria

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:
Current Illness:
Preexisting Conditions: migraines
Allergies:
Diagnostic Lab Data: N/A
CDC 'Split Type':

Write-up: hives and itching face after receiving the vaccination


Changed on 5/7/2021

VAERS ID: 916428 Before After
VAERS Form:2
Age:16.0
Sex:Female
Location:Texas
Vaccinated:2020-12-30
Onset:2020-12-30
Submitted:0000-00-00
Entered:2020-12-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037K20A / 1 LA / IM

Administered by: Public      Purchased by: ??
Symptoms: Pruritus, Urticaria

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:
Current Illness:
Preexisting Conditions: migraines
Allergies:
Diagnostic Lab Data: N/A
CDC 'Split Type':

Write-up: hives and itching face after receiving the vaccination


Changed on 5/14/2021

VAERS ID: 916428 Before After
VAERS Form:2
Age:16.0
Sex:Female
Location:Texas
Vaccinated:2020-12-30
Onset:2020-12-30
Submitted:0000-00-00
Entered:2020-12-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037K20A / 1 LA / IM

Administered by: Public      Purchased by: ??
Symptoms: Pruritus, Urticaria

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:
Current Illness:
Preexisting Conditions: migraines
Allergies:
Diagnostic Lab Data: N/A
CDC 'Split Type':

Write-up: hives and itching face after receiving the vaccination

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Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=916428&WAYBACKHISTORY=ON

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