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This is VAERS ID 907385

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History of Changes from the VAERS Wayback Machine

First Appeared on 12/30/2020

VAERS ID: 907385
VAERS Form:2
Age:31.0
Sex:Female
Location:Kentucky
Vaccinated:2020-12-22
Onset:2020-12-22
Submitted:0000-00-00
Entered:2020-12-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025JZOA / 1 RA / IM

Administered by: Unknown      Purchased by: ??
Symptoms: Dizziness, Heart rate irregular, Tachycardia

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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Initial c/o Lightheadedness within 15 min. of vaccine. Episodes of tachycardia 70''s - 140''s B/P 126/90 Patient monitored & revitaled 1620 B/P 120/72 HR IRREgular 1635 BP 120/72 HR Regular 1645 MD ON SCENE to ASSESS 1655 exited w/husbanD


Changed on 5/7/2021

VAERS ID: 907385 Before After
VAERS Form:2
Age:31.0
Sex:Female
Location:Kentucky
Vaccinated:2020-12-22
Onset:2020-12-22
Submitted:0000-00-00
Entered:2020-12-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025JZOA / 1 RA / IM

Administered by: Unknown      Purchased by: ??
Symptoms: Dizziness, Heart rate irregular, Tachycardia

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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Initial c/o Lightheadedness within 15 min. of vaccine. Episodes of tachycardia 70''s - 140''s B/P 126/90 Patient monitored & revitaled 1620 B/P 120/72 HR IRREgular 1635 BP 120/72 HR Regular 1645 MD ON SCENE to ASSESS 1655 exited w/husbanD


Changed on 5/14/2021

VAERS ID: 907385 Before After
VAERS Form:2
Age:31.0
Sex:Female
Location:Kentucky
Vaccinated:2020-12-22
Onset:2020-12-22
Submitted:0000-00-00
Entered:2020-12-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025JZOA / 1 RA / IM

Administered by: Unknown      Purchased by: ??
Symptoms: Dizziness, Heart rate irregular, Tachycardia

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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Initial c/o Lightheadedness within 15 min. of vaccine. Episodes of tachycardia 70''s - 140''s B/P 126/90 Patient monitored & revitaled 1620 B/P 120/72 HR IRREgular 1635 BP 120/72 HR Regular 1645 MD ON SCENE to ASSESS 1655 exited w/husbanD

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