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This is VAERS ID 1776083

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History of Changes from the VAERS Wayback Machine

First Appeared on 10/15/2021

VAERS ID: 1776083
VAERS Form:2
Age:45.0
Sex:Female
Location:Texas
Vaccinated:2021-10-08
Onset:2021-10-10
Submitted:0000-00-00
Entered:2021-10-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 301308A / UNK LA / SYR

Administered by: Pharmacy      Purchased by: ??
Symptoms: Erythema, Swelling, Urticaria

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: Vitamin D, Evening Primrose
Current Illness:
Preexisting Conditions:
Allergies: codeine
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: red swollen hives on neck started on Sunday evening, October 10 and have continued into Monday morning October 11

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