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VAERS ID: 1753039

AGE: 70| SEX: F|State: NY

Description

Headache, tired, achy, chills, nausea, felt like vomiting, loss of appetite, arm pain and temperature increased to 99.7

Symptoms

Body temperature increased, Nausea, Chills, Pain, Decreased appetite, Pain in extremity, Fatigue, Headache

Vaccines

VAX DATE: 16 February 2021 | ONSET DATE: 16 February 2021 | DAYS TO ONSET: 0
Vaccine TypeManufacturerVaccine NameDoseRouteSiteLot
  • COVID19
  • MODERNA
  • COVID19 (COVID19 (MODERNA))

        RECVDATE:
        01 October 2021
        CAGE_YR:
        70
        CAGE_MO:
        RPT_DATE:
        DIED:
        DATEDIED:
        L_THREAT:
        ER_VISIT:
        HOSPITAL:
        HOSPDAYS:
        X_STAY:
        DISABLE:
        RECOVD:
        Y
        LAB_DATA:
        none
        V_ADMINBY:
        PVT
        OTHER_MEDS:
        Metoprolol, Hydrochlorothiazide, Vitamin D3, Tylenol
        CUR_ILL:
        High Blood Pressure
        HISTORY:
        High Bloood Pressure
        PRIOR_VAX:
        Dizzy right after Shingles vaccine
        SPLTTYPE:
        FORM_VERS:
        2
        TODAYS_DATE:
        01 October 2021
        BIRTH_DEFECT:
        OFC_VISIT:
        ER_ED_VISIT:
        ALLERGIES:
        Codeine, Thimerosal, Lisinopril, Nickel
        V_FUNDBY:
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