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This is VAERS ID 1774996

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History of Changes from the VAERS Wayback Machine

First Appeared on 10/15/2021

VAERS ID: 1774996
VAERS Form:2
Age:57.0
Sex:Female
Location:Illinois
Vaccinated:2021-10-04
Onset:2021-10-04
Submitted:0000-00-00
Entered:2021-10-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Chills, Headache, Hyperhidrosis, Myalgia, Decreased appetite

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: no otc medications
Current Illness: patient declines other illness time of vaccine or month prior
Preexisting Conditions: patient declines chronic or long standing health conditions
Allergies: no known allergies
Diagnostic Lab Data: None patient evaluated in my clinic five days after vaccine and asymptomatic.
CDC 'Split Type':

Write-up: Patient reports symptoms started 8 hours after second pfizer vaccine. Reports chills, sweats, headache, loss of appeitie, terrible muscle pain, headache x 2 days straight.

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