Adverse Event Reporting

VAERS ID 916256
Gender Unknown
Age
StateCode KS
Pharmaceutical Company MODERNA
Lot Number Q11S2QA
Number of vaccinations 1
Vaccinated
Onset
Condition
Symptoms
  • Headache
  • Erythema
  • Injection site pain
  • Swelling

Current Illness

Preexisting Conditions

Other Medications

Previous Vaccinations

Allergies

Laboratory Data

Write-up

Headache - developed within first 30 minutes and lasted for 3 hours Redness, swelling, & pain at injection site - started 16 hours after injection