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This is VAERS ID 1490385

History of Changes from the VAERS Wayback Machine

First Appeared on 7/23/2021

VAERS ID: 1490385
VAERS Form:2
Age:42.0
Sex:Male
Location:Illinois
Vaccinated:2021-07-18
Onset:2021-07-18
Submitted:0000-00-00
Entered:2021-07-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 004D21A / 2 LA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Arthralgia, Pain, Joint range of motion decreased

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? Yes
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: ER visit 07/18/21
CDC 'Split Type':

Write-up: patient experiencing increasing pain in shoulder ultimately reducing range in motion and pain upon movement.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1490385&WAYBACKHISTORY=ON


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