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This is VAERS ID 1430106

History of Changes from the VAERS Wayback Machine

First Appeared on 7/2/2021

VAERS ID: 1430106
VAERS Form:2
Age:19.0
Sex:Male
Location:Indiana
Vaccinated:2021-06-26
Onset:2021-06-26
Submitted:0000-00-00
Entered:2021-06-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 1 RA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Flushing, Hyperhidrosis, Hyperventilation, Tinnitus, Visual impairment

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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Systemic: Flushed / Sweating-Medium, Systemic: Hyperventilation-Medium, Systemic: Tinnitus-Medium, Systemic: Visual Changes/Disturbances-Medium, Additional Details: 911 called. Patient evaluated by paramedics. Patient recovered and felt well enough to drive home. Patient refused hospital visit

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1430106&WAYBACKHISTORY=ON


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