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This is VAERS ID 1422358

History of Changes from the VAERS Wayback Machine

First Appeared on 6/25/2021

VAERS ID: 1422358
VAERS Form:2
Age:25.0
Sex:Female
Location:Massachusetts
Vaccinated:2021-06-20
Onset:2021-06-20
Submitted:0000-00-00
Entered:2021-06-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 002B21A / 2 LA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Unevaluable event

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: Unknown

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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1422358&WAYBACKHISTORY=ON


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