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This is VAERS ID 1679228

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History of Changes from the VAERS Wayback Machine

First Appeared on 9/10/2021

VAERS ID: 1679228
VAERS Form:2
Age:33.0
Sex:Female
Location:New York
Vaccinated:2021-09-05
Onset:2021-09-06
Submitted:0000-00-00
Entered:2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 048F21A / 1 LA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Chills, Fatigue, Headache, Injection site pain

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: None
Current Illness: None
Preexisting Conditions:
Allergies: None
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Injection site pain, headache, fatigue and chills.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1679228&WAYBACKHISTORY=ON


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