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This is VAERS ID 1376321

History of Changes from the VAERS Wayback Machine

First Appeared on 6/11/2021

VAERS ID: 1376321
VAERS Form:2
Age:58.0
Sex:Female
Location:Pennsylvania
Vaccinated:2021-06-01
Onset:2021-06-01
Submitted:0000-00-00
Entered:2021-06-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 054C21A / 1 AR / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Peripheral swelling

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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Systemic: Swelling of hand on side of injection-Medium

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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1376321&WAYBACKHISTORY=ON


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