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This is VAERS ID 1474678

History of Changes from the VAERS Wayback Machine

First Appeared on 7/16/2021

VAERS ID: 1474678
VAERS Form:2
Age:56.0
Sex:Female
Location:Minnesota
Vaccinated:2021-07-15
Onset:2021-07-15
Submitted:0000-00-00
Entered:2021-07-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0180 / 2 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Expired product administered

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: none listed
Current Illness: Nausea,
Preexisting Conditions: Diabetes, Dyslipidemia, Anemia, Lumbar disc disease with Radiculopathy, GERD, History of CVA, Asthma, Hypertension,
Allergies: Meperidine, Tramadol, Demerol, Haloperiodol, Lisinopril. Pencillins, Phenothiazines, Thorazine, Ultram, Hydroxyzine, Latex
Diagnostic Lab Data: none
CDC 'Split Type':

Write-up: Vaccine given 14 minutes past of being diluted. No reaction, no symptoms, Pfizer contacted and instructed to fill out form and they will take under advisement

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1474678&WAYBACKHISTORY=ON


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