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This is VAERS ID 1776598

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History of Changes from the VAERS Wayback Machine

First Appeared on 10/15/2021

VAERS ID: 1776598
VAERS Form:2
Age:32.0
Sex:Female
Location:New York
Vaccinated:2021-10-03
Onset:2021-10-04
Submitted:0000-00-00
Entered:2021-10-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 RA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Chills, Cold sweat, Headache, Malaise, 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:
Other Medications: Slynd 4mg daily Ropinirole 1 mg QHS daily multivitamin Sertraline 50 mg QHS
Current Illness: none
Preexisting Conditions: none
Allergies: NKA
Diagnostic Lab Data: none
CDC 'Split Type':

Write-up: Generally ill feeling. body aches, chills, cold sweat, headache, slight fever.

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