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This is VAERS ID 1750018

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History of Changes from the VAERS Wayback Machine

First Appeared on 10/1/2021

VAERS ID: 1750018
VAERS Form:2
Age:55.0
Sex:Female
Location:Texas
Vaccinated:2021-09-30
Onset:2021-09-30
Submitted:0000-00-00
Entered:2021-09-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (UNKNOWN)) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Private      Purchased by: ??
Symptoms: Dyspnoea, Heart rate increased

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? Yes, days: 45     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Celecoxib 100 MG prn, NovoLIN N 100 units qhs, Lisinopril 20 MG 1 tab BID, metFORMIN HCl ER 500 MG 3 tabs daily, Metoprolol Tartrate 100 MG 1 tab BID, Pravastatin Sodium 20 MG 1 tab daily
Current Illness: N/A
Preexisting Conditions: DM II, HTN, chronic numbness L lateral thigh, peripheral neuropathy, chronic back pain
Allergies: Demerol, clonidine, hydrocodone, Victoza
Diagnostic Lab Data: N/A
CDC 'Split Type':

Write-up: Given COVID Vaccine on 08/13/21, on 08/14/21 started having a hard time breathing, and a elevated heart rate, was taken to hospital on 08/14/21, pt recently moved to rehabilitation facility for continued care on 09/29/21

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