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This is VAERS ID 1768311

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History of Changes from the VAERS Wayback Machine

First Appeared on 10/8/2021

VAERS ID: 1768311
VAERS Form:2
Age:81.0
Sex:Female
Location:Unknown
Vaccinated:2021-10-05
Onset:2021-10-05
Submitted:0000-00-00
Entered:2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2587 / 3 - / SYR
FLUA4: INFLUENZA (SEASONAL) (FLUAD QUADRIVALENT) / SEQIRUS, INC. - / UNK - / -

Administered by: Pharmacy      Purchased by: ??
Symptoms: Asthenia, Fall, Urinary incontinence

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:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient complained of weakness the night after receipt of Pfizer booster and seasonal influenza vaccines. Resulted in a fall and mild urinary incontinence.

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