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This is VAERS ID 902465

History of Changes from the VAERS Wayback Machine

First Appeared on 12/18/2020

VAERS ID: 902465
VAERS Form:2
Age:60.0
Sex:Female
Location:Arkansas
Vaccinated:2020-12-15
Onset:2020-12-15
Submitted:0000-00-00
Entered:2020-12-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EH9899 / 1 RA / IM

Administered by: Public      Purchased by: ??
Symptoms: Dysgeusia, Paraesthesia, Parosmia, Sensory disturbance, Tremor, Oral pruritus, Paraesthesia oral

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: Lisinopril, HCTZ, lipitor, amyitrypline, lexapro, vitamins,
Current Illness: Bronchitis, finished prednisone on 12-13-20
Preexisting Conditions: hypertension, fibromyalgia
Allergies: Biaxin
Diagnostic Lab Data: BP.
CDC 'Split Type':

Write-up: Pt felt wave come over body @ 1218 starting in head and going down. Bad taste in mouth, tingling in body , legs, back , across stomach, BP 150/100 P 120@ 1219, EMS activated. BP 120/80, P 80 Pt alert and oriented, Pt declined transport and Benadryl. Symptoms come and go, pt feels better but then bad taste in mouth starts, shaking of hands, tingling starts again in stomach and back. @ 1300 pt requests Benadryl, 25 mg administered. Pt notified family by phone of circumstances and family in transit.@1324 BP 120/80, P 84, tongue tingling and pt reports smelling chemical smell. @1345 Pt complained of mouth itching, EMS activated and will transport to Medical Center. Pt oriented and transported at @13


Changed on 12/24/2020

VAERS ID: 902465 Before After
VAERS Form:2
Age:60.0
Sex:Female
Location:Arkansas
Vaccinated:2020-12-15
Onset:2020-12-15
Submitted:0000-00-00
Entered:2020-12-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EH9899 / 1 RA / IM

Administered by: Public      Purchased by: ??
Symptoms: Dysgeusia, Paraesthesia, Parosmia, Sensory disturbance, Tremor, Oral pruritus, Paraesthesia oral

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: Lisinopril, HCTZ, lipitor, amyitrypline, lexapro, vitamins,
Current Illness: Bronchitis, finished prednisone on 12-13-20
Preexisting Conditions: hypertension, fibromyalgia
Allergies: Biaxin Biaxin
Diagnostic Lab Data: BP.
CDC 'Split Type': (blank) VSafe

Write-up: Pt felt wave come over body @ 1218 starting in head and going down. Bad taste in mouth, tingling in body , legs, back , across stomach, BP 150/100 P 120@ 1219, EMS activated. BP 120/80, P 80 Pt alert and oriented, Pt declined transport and Benadryl. Symptoms come and go, pt feels better but then bad taste in mouth starts, shaking of hands, tingling starts again in stomach and back. @ 1300 pt requests Benadryl, 25 mg administered. Pt notified family by phone of circumstances and family in transit.@1324 BP 120/80, P 84, tongue tingling and pt reports smelling chemical smell. @1345 Pt complained of mouth itching, EMS activated and will transport to Medical Center. Pt oriented and transported at @13


Changed on 12/30/2020

VAERS ID: 902465 Before After
VAERS Form:2
Age:60.0
Sex:Female
Location:Arkansas
Vaccinated:2020-12-15
Onset:2020-12-15
Submitted:0000-00-00
Entered:2020-12-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EH9899 / 1 RA / IM

Administered by: Public      Purchased by: ??
Symptoms: Dysgeusia, Paraesthesia, Parosmia, Sensory disturbance, Tremor, Oral pruritus, Paraesthesia oral

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: Lisinopril, HCTZ, lipitor, amyitrypline, lexapro, vitamins,
Current Illness: Bronchitis, finished prednisone on 12-13-20
Preexisting Conditions: hypertension, fibromyalgia
Allergies: Biaxin Biaxin
Diagnostic Lab Data: BP.
CDC 'Split Type': VSafe

Write-up: Pt felt wave come over body @ 1218 starting in head and going down. Bad taste in mouth, tingling in body , legs, back , across stomach, BP 150/100 P 120@ 1219, EMS activated. BP 120/80, P 80 Pt alert and oriented, Pt declined transport and Benadryl. Symptoms come and go, pt feels better but then bad taste in mouth starts, shaking of hands, tingling starts again in stomach and back. @ 1300 pt requests Benadryl, 25 mg administered. Pt notified family by phone of circumstances and family in transit.@1324 BP 120/80, P 84, tongue tingling and pt reports smelling chemical smell. @1345 Pt complained of mouth itching, EMS activated and will transport to Medical Center. Pt oriented and transported at @13


Changed on 1/7/2021

VAERS ID: 902465 Before After
VAERS Form:2
Age:60.0
Sex:Female
Location:Arkansas
Vaccinated:2020-12-15
Onset:2020-12-15
Submitted:0000-00-00
Entered:2020-12-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EH9899 / 1 RA / IM

Administered by: Public      Purchased by: ??
Symptoms: Dysgeusia, Paraesthesia, Parosmia, Sensory disturbance, Tremor, Oral pruritus, Paraesthesia oral

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: Lisinopril, HCTZ, lipitor, amyitrypline, lexapro, vitamins,
Current Illness: Bronchitis, finished prednisone on 12-13-20
Preexisting Conditions: hypertension, fibromyalgia
Allergies: Biaxin
Diagnostic Lab Data: BP.
CDC 'Split Type': VSafe (blank)

Write-up: Pt felt wave come over body @ 1218 starting in head and going down. Bad taste in mouth, tingling in body , legs, back , across stomach, BP 150/100 P 120@ 1219, EMS activated. BP 120/80, P 80 Pt alert and oriented, Pt declined transport and Benadryl. Symptoms come and go, pt feels better but then bad taste in mouth starts, shaking of hands, tingling starts again in stomach and back. @ 1300 pt requests Benadryl, 25 mg administered. Pt notified family by phone of circumstances and family in transit.@1324 BP 120/80, P 84, tongue tingling and pt reports smelling chemical smell. @1345 Pt complained of mouth itching, EMS activated and will transport to Medical Center. Pt oriented and transported at @13

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