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This is VAERS ID 1704616

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History of Changes from the VAERS Wayback Machine

First Appeared on 9/17/2021

VAERS ID: 1704616
VAERS Form:2
Age:65.0
Sex:Female
Location:Florida
Vaccinated:2021-09-09
Onset:2021-09-10
Submitted:0000-00-00
Entered:2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 1 RA / IM

Administered by: Public      Purchased by: ??
Symptoms: Arthralgia, Chills, Erythema, Fatigue, Headache, Injection site pain, Malaise, Myalgia, Nausea, Pain in extremity, Swelling

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: Lisinopril 10 mg, rosuvastatin 10mg, hydrocodone 10-325
Current Illness:
Preexisting Conditions: Cervical disc disease, high blood pressure, sciatic nerve
Allergies: None
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Injection site pain,tiredness,headache,muscle pain,chills,joint pain,swelling,redness,nausea,feeling unwell,arm pain

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