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This is VAERS ID 1423697

History of Changes from the VAERS Wayback Machine

First Appeared on 6/25/2021

VAERS ID: 1423697
VAERS Form:2
Age:82.0
Sex:Female
Location:Illinois
Vaccinated:2021-06-04
Onset:2021-06-04
Submitted:0000-00-00
Entered:2021-06-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 005C21A / 2 RA / IM

Administered by: Other      Purchased by: ??
Symptoms: Asthenia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: NKA
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: Patient experienced weakness post vaccination, recovered and released

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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1423697&WAYBACKHISTORY=ON


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