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This is VAERS ID 1331466

History of Changes from the VAERS Wayback Machine

First Appeared on 5/21/2021

VAERS ID: 1331466
VAERS Form:2
Age:65.0
Sex:Male
Location:Unknown
Vaccinated:2021-05-03
Onset:2021-05-19
Submitted:0000-00-00
Entered:2021-05-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 007C21A / 1 LA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Cerebrovascular accident

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

Write-up: Per family member patient had a stroke and was admitted

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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1331466&WAYBACKHISTORY=ON


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