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This is VAERS ID 994913

History of Changes from the VAERS Wayback Machine

First Appeared on 2/4/2021

VAERS ID: 994913
VAERS Form:2
Age:48.0
Sex:Female
Location:Tennessee
Vaccinated:2021-01-30
Onset:2021-01-31
Submitted:0000-00-00
Entered:2021-02-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Senior Living      Purchased by: ??
Symptoms: Body temperature increased, Death, Nausea, Vomiting

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-02-01
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:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: patient passed away 2 days after vaccine. patient had temperature, nausea, and vomiting after vaccine.

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