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This is VAERS ID 911940

History of Changes from the VAERS Wayback Machine

First Appeared on 1/22/2021

VAERS ID: 911940
VAERS Form:2
Age:24.0
Sex:Female
Location:Indiana
Vaccinated:2020-12-29
Onset:2020-12-29
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, Feeling hot, Flushing, Facial paresis

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: 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


Changed on 5/7/2021

VAERS ID: 911940 Before After
VAERS Form:2
Age:24.0
Sex:Female
Location:Indiana
Vaccinated:2020-12-29
Onset:2020-12-29
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, Feeling hot, Flushing, Facial paresis

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: Breo, Albuterol, BIrth Control, Zurtec
Current Illness:
Preexisting Conditions: Asthma
Allergies: Penicillin, Singular Singular
Diagnostic Lab Data:
CDC 'Split Type':

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


Changed on 5/14/2021

VAERS ID: 911940 Before After
VAERS Form:2
Age:24.0
Sex:Female
Location:Indiana
Vaccinated:2020-12-29
Onset:2020-12-29
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, Feeling hot, Flushing, Facial paresis

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: Breo, Albuterol, BIrth Control, Zurtec
Current Illness:
Preexisting Conditions: Asthma
Allergies: Penicillin, Singular 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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