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History of Changes from the VAERS Wayback Machine |
VAERS ID: | 902575 |
VAERS Form: | 2 |
Age: | 55.0 |
Sex: | Male |
Location: | Florida |
Vaccinated: | 2020-12-15 |
Onset: | 2020-12-16 |
Submitted: | 0000-00-00 |
Entered: | 2020-12-16 |
Vaccination / Manufacturer (1 vaccine) | Lot / Dose | Site / Route |
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH | - / 1 | RA / IM |
Administered by: Unknown Purchased by: ??
Symptoms: Injection site pain, Pain in extremity
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)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: Iodine
Diagnostic Lab Data: None
CDC 'Split Type':
Write-up: Pain in deltoid muscle upon pressure at night. Hard to lay on the side of the vaccine due to pain in the arm
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