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This is VAERS ID 1443609

History of Changes from the VAERS Wayback Machine

First Appeared on 7/9/2021

VAERS ID: 1443609
VAERS Form:2
Age:74.0
Sex:Female
Location:Texas
Vaccinated:2021-06-25
Onset:2021-06-25
Submitted:0000-00-00
Entered:2021-07-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 050C21A / 1 LA / SYR

Administered by: Pharmacy      Purchased by: ??
Symptoms: Abdominal pain lower, Diarrhoea, Headache, Pyrexia, Vomiting

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: Lisinapril Setaline Glucose Senior Vitamin Omega 3 Vitamin C extended Release 65 Micrograms of iron 2x daily 2x Vitsaimin D capuls 2000 unit 2x daily Atorvastain
Current Illness:
Preexisting Conditions:
Allergies: Lisinapril Setaline Glucose Senior Vitamin Omega 3 Vitamin C extended Release 65 Micrograms of iron 2x daily 2x Vitsaimin D capuls 2000 unit 2x daily Atorvastain
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient stated that she received a pain in her lower abdomen. She woke up in the middle of the night with a fever and loose bowel movement. When she made it back to her bed she started vomiting. Patient also states that she had a serve headache. Patient stated that she had loose stool for five days. She could only keep down water and sports drink.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1443609&WAYBACKHISTORY=ON

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