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This is VAERS ID 1689022

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History of Changes from the VAERS Wayback Machine

First Appeared on 9/17/2021

VAERS ID: 1689022
VAERS Form:2
Age:54.0
Sex:Female
Location:Minnesota
Vaccinated:2021-04-06
Onset:2021-09-08
Submitted:0000-00-00
Entered:2021-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 032B21A / 2 RA / IM

Administered by: Private      Purchased by: ??
Symptoms: 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? No
Previous Vaccinations:
Other Medications: Patient swabbed at our offsite testing center. No primary care provider listed on file for them.
Current Illness: Patient swabbed at our offsite testing center. No primary care provider listed on file for them.
Preexisting Conditions: Patient swabbed at our offsite testing center. No primary care provider listed on file for them.
Allergies: Patient swabbed at our offsite testing center. No primary care provider listed on file for them.
Diagnostic Lab Data: Patient swabbed at our offsite testing center. No primary care provider listed on file for them.
CDC 'Split Type':

Write-up: Patient vaccinated and then tested positive for COVID-19

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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1689022&WAYBACKHISTORY=ON


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