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This is VAERS ID 1693836

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History of Changes from the VAERS Wayback Machine

First Appeared on 9/17/2021

VAERS ID: 1693836
VAERS Form:2
Age:54.0
Sex:Female
Location:Connecticut
Vaccinated:2021-09-13
Onset:2021-09-13
Submitted:0000-00-00
Entered:2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 RA / IM

Administered by: Work      Purchased by: ??
Symptoms: Alopecia, Arthralgia, Diarrhoea

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: none
Allergies: none
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: joint pain. hair loss, diarrrhea since shot till present.

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