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This is VAERS ID 1462040

History of Changes from the VAERS Wayback Machine

First Appeared on 7/16/2021

VAERS ID: 1462040
VAERS Form:2
Age:58.0
Sex:Female
Location:Texas
Vaccinated:2021-07-03
Onset:2021-07-03
Submitted:0000-00-00
Entered:2021-07-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 009D21A / 1 LA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Erythema, Pruritus, Swelling

Life Threatening? No
Birth Defect? No
Died? No
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? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: Redness, swelling, itching lasting 7 days

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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1462040&WAYBACKHISTORY=ON


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