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This is VAERS ID 1467973

History of Changes from the VAERS Wayback Machine

First Appeared on 7/16/2021

VAERS ID: 1467973
VAERS Form:2
Age:26.0
Sex:Female
Location:Georgia
Vaccinated:2021-07-13
Onset:2021-07-13
Submitted:0000-00-00
Entered:2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 078C21A / 1 LA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Syncope

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: N/A
Current Illness: None
Preexisting Conditions: None
Allergies: NKDA
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient fainted after the shot, but quickly became responsive.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1467973&WAYBACKHISTORY=ON

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