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This is VAERS ID 1396373

History of Changes from the VAERS Wayback Machine

First Appeared on 6/18/2021

VAERS ID: 1396373
VAERS Form:2
Age:82.0
Sex:Male
Location:New Jersey
Vaccinated:2021-03-11
Onset:2021-06-03
Submitted:0000-00-00
Entered:2021-06-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / IM

Administered by: Private      Purchased by: ??
Symptoms: Audiogram, Deafness bilateral

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? Yes
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications: bumex, coreg, Aldactone, vitamin d
Current Illness: no
Preexisting Conditions: HTN, pacemaker, urinary implant device for incontinence
Allergies: flecainaide
Diagnostic Lab Data: Audiogram 6/10/2021
CDC 'Split Type':

Write-up: woke up on June 3rd and could not hear. lost complete hearing in one ear. the other ear is profound hearing lost.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1396373&WAYBACKHISTORY=ON


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