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This is VAERS ID 1461745

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History of Changes from the VAERS Wayback Machine

First Appeared on 7/16/2021

VAERS ID: 1461745
VAERS Form:2
Age:63.0
Sex:Female
Location:Arizona
Vaccinated:2021-05-16
Onset:2021-05-21
Submitted:0000-00-00
Entered:2021-07-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA ? / 1 AR / SYR

Administered by: Pharmacy      Purchased by: ??
Symptoms: Pneumonia, COVID-19, COVID-19 pneumonia

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-06-14
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? Yes, days: 21     Extended hospital stay? No
Previous Vaccinations:
Other Medications: I can send you all20 of her medical list in an email if needed! My mom had Almost every heath issue there could be!
Current Illness: MS, diabetes, high blood pressure, neuropathy, tremors
Preexisting Conditions: MS,high blood pressure, neuropathy, tremors slipped discs, diabetes
Allergies: None
Diagnostic Lab Data: I can have a letter from her dr
CDC 'Split Type':

Write-up: Developed pneumonia 5 days was hospitalized 2 days later and tested positive for covid pneumonia

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