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This is VAERS ID 1329861

History of Changes from the VAERS Wayback Machine

First Appeared on 5/28/2021

VAERS ID: 1329861
VAERS Form:2
Age:25.0
Sex:Female
Location:California
Vaccinated:2021-05-18
Onset:2021-05-18
Submitted:0000-00-00
Entered:2021-05-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 033B21 / 1 LA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Dizziness, Headache, Hypotension, Nausea, Syncope, Unresponsive to stimuli

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Systemic: Dizziness / Lightheadness-Medium, Systemic: Fainting / Unresponsive-Medium, Systemic: Headache-Medium, Systemic: Hypotension-Medium, Systemic: Nausea-Medium, Additional Details: 911 was called immediately.Parametics monitored patients BP and over all alertness at the store. Patient was adviced by the parametics to go to ER. Pt declined and had to sign AMA (against medical advice) form.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1329861&WAYBACKHISTORY=ON


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