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This is VAERS ID 1696912

History of Changes from the VAERS Wayback Machine

First Appeared on 9/17/2021

VAERS ID: 1696912
VAERS Form:2
Age:54.0
Sex:Female
Location:New York
Vaccinated:2021-09-13
Onset:2021-09-14
Submitted:0000-00-00
Entered:2021-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 062K21A / 2 LA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Arthralgia, Dizziness, Headache, Myalgia, Pyrexia

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)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: asthma
Allergies: ciprofloxin
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Dizziness, headache, muscle ache, joint ache, fever

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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1696912&WAYBACKHISTORY=ON

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