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This is VAERS ID 913688

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History of Changes from the VAERS Wayback Machine

First Appeared on 1/29/2021

VAERS ID: 913688
VAERS Form:2
Age:19.0
Sex:Male
Location:Virginia
Vaccinated:2020-12-28
Onset:2020-12-28
Submitted:0000-00-00
Entered:2020-12-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK RA / SYR

Administered by: Unknown      Purchased by: ??
Symptoms: Headache, Pain

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

Write-up: Body Aches lasting to present, headaches lasting to present


Changed on 5/7/2021

VAERS ID: 913688 Before After
VAERS Form:2
Age:19.0
Sex:Male
Location:Virginia
Vaccinated:2020-12-28
Onset:2020-12-28
Submitted:0000-00-00
Entered:2020-12-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK RA / SYR

Administered by: Unknown      Purchased by: ??
Symptoms: Headache, Pain

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

Write-up: Body Aches lasting to present, headaches lasting to present


Changed on 5/14/2021

VAERS ID: 913688 Before After
VAERS Form:2
Age:19.0
Sex:Male
Location:Virginia
Vaccinated:2020-12-28
Onset:2020-12-28
Submitted:0000-00-00
Entered:2020-12-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK RA / SYR

Administered by: Unknown      Purchased by: ??
Symptoms: Headache, Pain

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

Write-up: Body Aches lasting to present, headaches lasting to present

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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=913688&WAYBACKHISTORY=ON


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