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From the 7/23/2021 release of VAERS data:

This is VAERS ID 1301665



Case Details

VAERS ID: 1301665 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-30
Onset:2021-05-02
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-05-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 001CZ1A (NOT SU / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Herpes zoster
SMQs:, Opportunistic infections (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Levothyroxine Ursodiol
Current Illness: None
Preexisting Conditions: Scleroderma Primary Biliary cirrhosis Hypothyroid Sjogrens
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Shingles outbreak


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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1301665


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