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From the 6/11/2021 release of VAERS data:

This is VAERS ID 911940



Case Details

VAERS ID: 911940 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Indiana  
Vaccinated:2020-12-29
Onset:2020-12-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2020-12-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 026L201 / UNK UN / IM

Administered by: Other       Purchased by: ?
Symptoms: Dizziness, Facial paresis, Feeling hot, Flushing
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Vestibular disorders (broad), Hypersensitivity (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Breo, Albuterol, BIrth Control, Zurtec
Current Illness:
Preexisting Conditions: Asthma
Allergies: Penicillin, Singular
Diagnostic Lab Data:
CDC Split Type:

Write-up: Became hot, flushed and felt dizzy,. Had slight weakness in rt face


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Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=911940


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