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This is VAERS ID 1744277

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History of Changes from the VAERS Wayback Machine

First Appeared on 10/1/2021

VAERS ID: 1744277
VAERS Form:2
Age:60.0
Sex:Male
Location:New York
Vaccinated:2021-09-27
Onset:2021-09-29
Submitted:0000-00-00
Entered:2021-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011F21A / 1 RA / IM

Administered by: Private      Purchased by: ??
Symptoms: Back pain, Headache, Neck pain, Pruritus, Vision blurred

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: NO
Current Illness: NO
Preexisting Conditions: NO
Allergies: NO
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Lower Back Pain; Blurry Vision; Sides of head temple and neck Pain; Itchy legs and arms; Throbbing''s behind ears

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1744277&WAYBACKHISTORY=ON


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