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History of Changes from the VAERS Wayback Machine |
VAERS ID: | 902490 |
VAERS Form: | 2 |
Age: | 37.0 |
Sex: | Female |
Location: | New Mexico |
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 | LA / IM |
Administered by: Private Purchased by: ??
Symptoms: Headache, Pain
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: Benzoyl peroxide 10% gel, Biofreeze topical gel, Cyclobenzaprine 10mg tab, moisturizing cream, naproxen 250 mg tab, ondansetrn 4mg ODT tab, Refresh Tears
Current Illness: None
Preexisting Conditions: acne, astigmatism, myopia
Allergies: NKDA
Diagnostic Lab Data:
CDC 'Split Type':
Write-up: Headache, body ache
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 | LA / IM |
Administered by: Private Purchased by: ??
Symptoms: Headache, Pain
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: Benzoyl peroxide 10% gel, Biofreeze topical gel, Cyclobenzaprine 10mg tab, moisturizing cream, naproxen 250 mg tab, ondansetrn 4mg ODT tab, Refresh Tears
Current Illness: None
Preexisting Conditions: acne, astigmatism, myopia
Allergies: NKDA NKDA
Diagnostic Lab Data:
CDC 'Split Type':
Write-up: Headache, body ache
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 | LA / IM |
Administered by: Private Purchased by: ??
Symptoms: Headache, Pain
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: Benzoyl peroxide 10% gel, Biofreeze topical gel, Cyclobenzaprine 10mg tab, moisturizing cream, naproxen 250 mg tab, ondansetrn 4mg ODT tab, Refresh Tears
Current Illness: None
Preexisting Conditions: acne, astigmatism, myopia
Allergies: NKDA
NKDA
Diagnostic Lab Data:
CDC 'Split Type':
Write-up: Headache, body ache
Link To This Search Result:
https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=902490&WAYBACKHISTORY=ON
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