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This is VAERS ID 1423518

History of Changes from the VAERS Wayback Machine

First Appeared on 6/25/2021

VAERS ID: 1423518
VAERS Form:2
Age:59.0
Sex:Male
Location:Florida
Vaccinated:2021-04-06
Onset:2021-06-04
Submitted:0000-00-00
Entered:2021-06-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 020821A / 1 LA / SYR

Administered by: Private      Purchased by: ??
Symptoms: Headache, Migraine

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? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: N/A
Preexisting Conditions: Asthma, herniated disc (L5)
Allergies: N/A
Diagnostic Lab Data: N/A
CDC 'Split Type':

Write-up: Acutely Migraines, Prolonged Headaches, 5/4/2021 Until present (6/24/2021)

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1423518&WAYBACKHISTORY=ON

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