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This is VAERS ID 1759496

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History of Changes from the VAERS Wayback Machine

First Appeared on 10/8/2021

VAERS ID: 1759496
VAERS Form:2
Age:67.0
Sex:Female
Location:California
Vaccinated:2021-10-04
Onset:2021-10-04
Submitted:0000-00-00
Entered:2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF8841 / 3 LA / IM
FLU4: INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE QUADRIVALENT) / SANOFI PASTEUR UJ742AA / 1 RA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Chest discomfort, 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: None
Current Illness: Unknown
Preexisting Conditions: None listed
Allergies: Dye (IVP) per pt
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: Patient stated chest tightness and her arm felt numb. started about 10 minutes after patient had vaccine.

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