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This is VAERS ID 1371088

History of Changes from the VAERS Wayback Machine

First Appeared on 6/4/2021

VAERS ID: 1371088
VAERS Form:2
Age:38.0
Sex:Female
Location:Minnesota
Vaccinated:2021-06-02
Onset:2021-06-03
Submitted:0000-00-00
Entered:2021-06-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025C21A / 1 RA / IM

Administered by: Senior Living      Purchased by: ??
Symptoms: Arthralgia, Pain in extremity, Peripheral swelling, Impaired work ability

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)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: No medications
Current Illness: fibromyalgia
Preexisting Conditions: None
Allergies: Sulfa and morphine
Diagnostic Lab Data: Staff memeber will be going to urgent care when it opens today @ 10:00. She was sent home at this time.
CDC 'Split Type':

Write-up: Staff member received vaccination @ 10:35 on 6/2/2021 @ Health Care Center from nurse . She awakened this morning with swelling and pain noted to the right index and middle finger on the right hand. She received her injection on the right arm. Staff member complains of all over joint pain. She does have a history of fibromyalgia. She has not other symptoms at this time.

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