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This is VAERS ID 1775675

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History of Changes from the VAERS Wayback Machine

First Appeared on 10/15/2021

VAERS ID: 1775675
VAERS Form:2
Age:38.0
Sex:Male
Location:Georgia
Vaccinated:2021-10-04
Onset:2021-10-04
Submitted:0000-00-00
Entered:2021-10-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2589 / 2 - / -

Administered by: Pharmacy      Purchased by: ??
Symptoms: Abdominal discomfort, Chest pain, Dizziness, Headache, Vaccination complication

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)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient stated he had an adverse reaction following 2 nd dose of Pfizer COVID-19 vaccine. Symptoms included headache, dizziness, abdominal discomfort, and chest pain. Patient visited ER where he was cleared and no further treatment was advised at this time.

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