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This is VAERS ID 1487446

History of Changes from the VAERS Wayback Machine

First Appeared on 7/23/2021

VAERS ID: 1487446
VAERS Form:2
Age:81.0
Sex:Male
Location:Arkansas
Vaccinated:2021-02-01
Onset:2021-07-08
Submitted:0000-00-00
Entered:2021-07-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Unknown      Purchased by: ??
Symptoms: Dyspnoea, Pyrexia, COVID-19, SARS-CoV-2 test positive

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: 7/8/2021 POSITIVE COVID TEST
CDC 'Split Type':

Write-up: PATIENT ADMITTED TO REHAB FROM DR''S OFFICE COMPLETED MODERNA VACCINATIONS THE 1ST OF FEBRUARY PER PATIENT STATEMENT ADMITTED TO ACUTE CARE 7/19/21 WITH INTERMITTENT FEVER, SOB STILL INPATIENT

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