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This is VAERS ID 1761601

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History of Changes from the VAERS Wayback Machine

First Appeared on 10/8/2021

VAERS ID: 1761601
VAERS Form:2
Age:47.0
Sex:Female
Location:Unknown
Vaccinated:2021-09-13
Onset:2021-09-14
Submitted:0000-00-00
Entered:2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Unknown      Purchased by: ??
Symptoms: Asthenia, Erythema, Hypoaesthesia, Pain in extremity, Swelling

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: vitamin D 2 Vitamin B12 fish oil tumeric
Current Illness: none
Preexisting Conditions: fibroids MTHFR mutation
Allergies: morphine pcn
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: I did not personally give vaccine since administration of vaccine on 9/13/2021 pt has had pain in upper arm- but then subsequent- after normal immune redness and swelling pt has been experiencing numbness and weakness of upper arm from deltoid to elbow.

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