Adverse Event Reporting

VAERS ID 1831623
Gender Female
Age 76
StateCode MI
Pharmaceutical Company MODERNA
Lot Number 939904
Number of vaccinations 3
Vaccinated 2021-10-26
Onset 2021-10-28
Condition Recovered
Symptoms
  • Injection site erythema
  • Local reaction
  • Injection site pruritus
  • Injection site warmth

Current Illness

none

Preexisting Conditions

Asthma, HTN, Depression/anxiety

Other Medications

Magnesium, Calcium, aleve, acidophyllis Certirizine 10 mg; Advair 100/50; ecitalipram 20mg; Buproprion 300XL; HCTZ 25 mg, ; simvastatin 40mg; omeprozole 20mg

Previous Vaccinations

Allergies

opioids

Laboratory Data

none

Write-up

Localized reaction left upper arm 2-3" wide approx 5" long, erythematous, +pruritis, warmth.