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This is VAERS ID 1301665

History of Changes from the VAERS Wayback Machine

First Appeared on 5/21/2021

VAERS ID: 1301665
VAERS Form:2
Age:45.0
Sex:Female
Location:California
Vaccinated:2021-04-30
Onset:2021-05-02
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

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: 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&WAYBACKHISTORY=ON


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