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This is VAERS ID 1697770

History of Changes from the VAERS Wayback Machine

First Appeared on 9/17/2021

VAERS ID: 1697770
VAERS Form:2
Age:26.0
Sex:Male
Location:Alaska
Vaccinated:2021-09-14
Onset:2021-09-14
Submitted:0000-00-00
Entered:2021-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 014F21A / 1 LA / SYR

Administered by: Pharmacy      Purchased by: ??
Symptoms: Feeling cold, Injection site paraesthesia, Paraesthesia, Tremor, Injection site hypoaesthesia

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)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: asthma
Preexisting Conditions: asthma
Allergies: pets, rarely food
Diagnostic Lab Data: unknown
CDC 'Split Type':

Write-up: pt reported numbness in the left arm at the injection site with little tingling within 1 minute of injection. progressed to whole arm tingling within 5 minutes. within 15 to 20min right hand started tingling, also reported feeling cold. 30 to 45 minutes small leg tremors. called 911. ambulance and emts took pt at about 1 hour after vaccine.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1697770&WAYBACKHISTORY=ON

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