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This is VAERS ID 1376695

History of Changes from the VAERS Wayback Machine

First Appeared on 6/11/2021

VAERS ID: 1376695
VAERS Form:2
Age:42.0
Sex:Male
Location:Georgia
Vaccinated:2021-05-29
Onset:2021-06-01
Submitted:0000-00-00
Entered:2021-06-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Fatigue, Nausea, Vomiting

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

Write-up: Patient has had nausea, vomiting, and fatigue for 5 days after getting vaccine. Patient thinks he may have COVID. Patient vaccinated at different facility. limited info

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1376695&WAYBACKHISTORY=ON


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