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This is VAERS ID 1376636

History of Changes from the VAERS Wayback Machine

First Appeared on 6/11/2021

VAERS ID: 1376636
VAERS Form:2
Age:32.0
Sex:Female
Location:Maryland
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 050C21A / 1 - / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Dyspnoea

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: Trouble breathing

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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1376636&WAYBACKHISTORY=ON


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