Adverse Event Reporting

VAERS ID 916041
Gender Unknown
Age 55
StateCode TX
Pharmaceutical Company MODERNA
Lot Number 025L20A
Number of vaccinations 1
Vaccinated 2020-12-30
Onset 2020-12-30
Condition
Symptoms
  • Pain in extremity
  • Peripheral swelling
  • Headache
  • Erythema
  • Myalgia

Current Illness

HBP, high cholesterol, fibromyalgia

Preexisting Conditions

same

Other Medications

None

Previous Vaccinations

Allergies

Cipro, levaquean

Laboratory Data

Write-up

Next day with redness welling pain (L) arm (3cm) Headache muscle ache .
txt with Ibuprofen antihistamines