Adverse Event Reporting
| VAERS ID | 911854 |
|---|---|
| Gender | Female |
| Age | 70 |
| StateCode | CT |
| Pharmaceutical Company | MODERNA |
| Lot Number | 011J20A |
| Number of vaccinations | 1 |
| Vaccinated | 2020-12-23 |
| Onset | 2020-12-24 |
| Condition | Permanent Disability |
Symptoms
- Pain in extremity
- Pain
- Back pain
- Neck pain
Current Illness
High blood pressure, cholestrol
Preexisting Conditions
high blood pressure, cholesterol, obesity
Other Medications
Losarten, pravastan, B-12
Previous Vaccinations
Allergies
allergy to pineapple skin
Laboratory Data
none
Write-up
I received the vaccine shot on 12/23/20 at 3 pm.
By 12/24/20, I had pain in my left arm that radiated to my neck and back on the left side.
Over the past 4/5 days, I continue to have pain in my left arm, back and neck