VAERS ID: 2315263

AGE: 33| SEX: F|STATE: TX

Description

Systemic: Allergic: Rash (specify: facial area, extremeties)-Medium, Systemic: Lymph Node Swelling-Medium, Additional Details: Patient was having rash the following day on the lower extremities, and swollen lympnodes

Symptoms

Lymphadenopathy, Rash

Vaccines

VAX DATE: 05-31-2022| ONSET DATE: 06-01-2022| DAYS TO ONSET: 1
NameDose #TypeManufacturerLotRouteSite
COVID19 (COVID19 (MODERNA)) 3 COVID19 MODERNA 037A22B IM LA

RECVDATE:06-10-2022
RPT_DATE:
CAGE_YR:33
CAGE_MO:
DIED:U
DATEDIED:
L_THREAT:U
ER_VISIT:U
HOSPITAL:U
HOSPDAYS:
X_STAY:U
DISABLE:U
RECOVD:Y
LAB_DATA:
V_ADMINBY:PHM
OTHER_MEDS:
CUR_ILL:
HISTORY:
PRIOR_VAX:
SPLTTYPE:
FORM_VERS:2
TODAYS_DATE:06-10-2022
BIRTH_DEFECT:U
OFC_VISIT:U
ER_ED_VISIT:U
ALLERGIES:
V_FUNDBY:

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