VAERS ID: 1708037

AGE: 29| SEX: F|STATE: NC (United States)

Description

Systemic: Allergic: Rash (specify: facial area, extremeties)-Medium, Systemic: Headache-Medium

Open in Wayback Machine
(If this is a foreign report without a description you will be able to read the description in the Wayback Machine on Medalerts if the report became public for the first time before November 18, 2022.)

Symptoms

Rash, Headache

Vaccines

VAX DATE: 09-05-2021| ONSET DATE: 09-05-2021| DAYS TO ONSET: 0
NameDose #TypeManufacturerLotRouteSite
COVID19 (COVID19 (MODERNA)) 2 COVID19 MODERNA 025C IM LA

RECVDATE:09-17-2021
RPT_DATE:
CAGE_YR:29
CAGE_MO:
DIED:U
DATEDIED:
L_THREAT:U
ER_VISIT:
HOSPITAL:U
HOSPDAYS:
X_STAY:U
DISABLE:U
RECOVD:N
LAB_DATA:
V_ADMINBY:PHM
OTHER_MEDS:
CUR_ILL:
HISTORY:
PRIOR_VAX:
SPLTTYPE:
FORM_VERS:
TODAYS_DATE:09-17-2021
BIRTH_DEFECT:U
OFC_VISIT:U
ER_ED_VISIT:U
ALLERGIES:
V_FUNDBY:

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