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This is VAERS ID 1764764

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History of Changes from the VAERS Wayback Machine

First Appeared on 10/8/2021

VAERS ID: 1764764
VAERS Form:2
Age:81.0
Sex:Male
Location:Ohio
Vaccinated:2021-09-29
Onset:2021-09-30
Submitted:0000-00-00
Entered:2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EWO183 / 1 LA / IM

Administered by: Unknown      Purchased by: ??
Symptoms: Lethargy, Nausea, Pain, Pyrexia

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: Dizzy, 80, Pfizer Covid 2
Other Medications: Pravastatin, Protonix, Restatis, Mirtazapine, Meloxicam, Multi-vitamin
Current Illness: None
Preexisting Conditions: Lumbar Spondylosis
Allergies: None Known
Diagnostic Lab Data: none
CDC 'Split Type':

Write-up: Nausea, very lethargic, whole body ache, dizzy, elevated temperature, over 24 hour period

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