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This is VAERS ID 1385520

History of Changes from the VAERS Wayback Machine

First Appeared on 6/11/2021

VAERS ID: 1385520
VAERS Form:2
Age:18.0
Sex:Male
Location:Indiana
Vaccinated:2021-06-03
Onset:2021-06-04
Submitted:0000-00-00
Entered:2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Pharmacy      Purchased by: ??
Symptoms: Body temperature increased, Cough, Dysphonia, Headache, Insomnia

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: cough, 18 yo, 4/29/21, COVID-19, Moderna
Other Medications: Levothyroxine 100mcg/day, Focalin XR 30mg qd, MVI, Claritin 10mg qd, Singulair 10mg qd
Current Illness: None
Preexisting Conditions: ADHD, allergic rhinitis, autism, hypothyroidism
Allergies: None
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: Severe dry cough, temperate max = 99.4, hoarseness, headache, insomnia

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