Adverse Event Reporting

VAERS ID 1849001
Gender Female
Age 73
StateCode FL
Pharmaceutical Company MODERNA
Lot Number 939904
Number of vaccinations 3
Vaccinated 2021-11-01
Onset 2021-11-02
Condition Recovered
Symptoms
  • Injection site pain
  • Injection site erythema
  • Injection site swelling
  • Injection site pruritus

Current Illness

Preexisting Conditions

Renal insufficiency; depression

Other Medications

Antidepressants; thyroid meds; sleeping aids

Previous Vaccinations

Allergies

Laboratory Data

Write-up

Swelling; pain; redness itching at injection site.
Red, itchy oval became 2" by 2 ½.
" Continued to itch after pain ceased.
Still a little itchy 11/6/2021.
Redness almost gone.