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This is VAERS ID 918390

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History of Changes from the VAERS Wayback Machine

First Appeared on 2/18/2021

VAERS ID: 918390
VAERS Form:2
Age:18.0
Sex:Female
Location:Vermont
Vaccinated:2020-12-31
Onset:2020-12-31
Submitted:0000-00-00
Entered:2021-01-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 039K20A / 1 AR / IM

Administered by: Private      Purchased by: ??
Symptoms: Pruritus, Throat tightness

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)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: tightness in throat, had initial itching in arm


Changed on 5/7/2021

VAERS ID: 918390 Before After
VAERS Form:2
Age:18.0
Sex:Female
Location:Vermont
Vaccinated:2020-12-31
Onset:2020-12-31
Submitted:0000-00-00
Entered:2021-01-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 039K20A / 1 AR / IM

Administered by: Private      Purchased by: ??
Symptoms: Pruritus, Throat tightness

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)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: tightness in throat, had initial itching in arm


Changed on 5/21/2021

VAERS ID: 918390 Before After
VAERS Form:2
Age:18.0
Sex:Female
Location:Vermont
Vaccinated:2020-12-31
Onset:2020-12-31
Submitted:0000-00-00
Entered:2021-01-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 039K20A / 1 AR / IM

Administered by: Private      Purchased by: ??
Symptoms: Pruritus, Throat tightness

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)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: tightness in throat, had initial itching in arm

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=918390&WAYBACKHISTORY=ON


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