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History of Changes from the VAERS Wayback Machine |
VAERS ID: | 2420144 |
VAERS Form: | 2 |
Age: | 4.0 |
Sex: | Female |
Location: | Pennsylvania |
Vaccinated: | 2022-08-25 |
Onset: | 2022-08-25 |
Submitted: | 0000-00-00 |
Entered: | 2022-08-25 |
Vaccination / Manufacturer (2 vaccines) | Lot / Dose | Site / Route |
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA | AS1412B / 2 | LA / IM |
FLU4: INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE QUADRIVALENT) / SANOFI PASTEUR | UT7682LA / N/A | LA / IM |
Administered by: Private Purchased by: ??
Symptoms: Rash, Rash maculo-papular
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? Yes
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: URI (cough and rhinorrhea) 3 weeks prior to vaccination
Preexisting Conditions: autism
Allergies: none
Diagnostic Lab Data: n/a
CDC 'Split Type':
Write-up: maculopapular rash on bil;ateral arms and legss and mildly also on abdomen, starting ~30mins after vaccines in left arm. No anaphylaxis (no hives, no hypotension, no GI sx, no wheezing). Rash started to fade over next 20-30. Not fully gone at 1hr when discharged
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