Adverse Event Reporting

VAERS ID 920804
Gender Unknown
Age 39
StateCode OR
Pharmaceutical Company MODERNA
Lot Number 011J20A
Number of vaccinations
Vaccinated 2020-12-29
Onset 2020-12-30
Condition
Symptoms
  • Pain in extremity
  • Hypoaesthesia
  • Headache
  • Paraesthesia
  • Nausea

Current Illness

Preexisting Conditions

Other Medications

Previous Vaccinations

Allergies

Laboratory Data

Write-up

patient reports numbness, pain, and tingling in arm; as well as Nausea and headache.
Nausea and headache lasted 2 days, pain in arm persists.