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From the 1/7/2021 release of VAERS data:

This is VAERS ID 36486

Case Details

VAERS ID: 36486 (history)  
Form: Version 1.0  
Age: 78.0  
Sex: Female  
Location: California  
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 1991-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Public       Purchased by: Unknown
Symptoms: Dizziness, Hypokinesia, Infection, Lung disorder, Myalgia, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications:
Current Illness: NONE
Preexisting Conditions: Hypertension, "mild heartattack" in Jun, 1991
Diagnostic Lab Data: CXR-showed Bilateral infiltrates;
CDC Split Type: CA91133

Write-up: At about MN, dizzy, unable to stand, vomiting; Ambulance transported pt to Hosp; treated w/IV ATB x 5 days, discharged on po ATB; no fever or cold sx; myalgia;

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