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This is VAERS ID 1375975

History of Changes from the VAERS Wayback Machine

First Appeared on 6/11/2021

VAERS ID: 1375975
VAERS Form:2
Age:36.0
Sex:Female
Location:Unknown
Vaccinated:2021-06-04
Onset:2021-06-04
Submitted:0000-00-00
Entered:2021-06-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 033B21A / 2 LA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Dizziness, Injury

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? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient felt dizzy/lightheaded about 15 minutes after the vaccine - as she was getting up she fell and hit her chin - had to lay down and felt better after some rest and intaking water/food. No need

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1375975&WAYBACKHISTORY=ON


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