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VAERS ID: 1708029

AGE: 31| SEX: F|State: IN

Description

Site: Pain at Injection Site-Mild, Site: Redness at Injection Site-Medium, Site: Swelling at Injection Site-Medium, Additional Details: Patient has a large knot that developed and has swollen and is red/warm to the touch. Concerned because she is 48 hours post shot and still having symptoms.

Symptoms

Injection site erythema, Injection site nodule, Injection site pain, Injection site swelling, Injection site warmth

Vaccines

VAX DATE: 10 September 2021 | ONSET DATE: 11 September 2021 | DAYS TO ONSET: 1
Vaccine TypeManufacturerVaccine NameDoseRouteSiteLot
  • COVID19
  • MODERNA
  • COVID19 (COVID19 (MODERNA))

        RECVDATE:
        17 September 2021
        CAGE_YR:
        31
        CAGE_MO:
        RPT_DATE:
        DIED:
        DATEDIED:
        L_THREAT:
        ER_VISIT:
        HOSPITAL:
        HOSPDAYS:
        X_STAY:
        DISABLE:
        RECOVD:
        N
        LAB_DATA:
        V_ADMINBY:
        PHM
        OTHER_MEDS:
        CUR_ILL:
        HISTORY:
        PRIOR_VAX:
        SPLTTYPE:
        FORM_VERS:
        2
        TODAYS_DATE:
        17 September 2021
        BIRTH_DEFECT:
        OFC_VISIT:
        ER_ED_VISIT:
        ALLERGIES:
        V_FUNDBY:
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