National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 902837

Government Disclaimer on use of this data

History of Changes from the VAERS Wayback Machine

First Appeared on 12/18/2020

VAERS ID: 902837
VAERS Form:2
Age:29.0
Sex:Female
Location:Alaska
Vaccinated:2020-12-16
Onset:2020-12-16
Submitted:0000-00-00
Entered:2020-12-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK5730 / 1 - / IM

Administered by: Private      Purchased by: ??
Symptoms: Anxiety, Dysphagia, Tearfulness

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)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient feeling very anxious before and after vaccination. Described having difficulty swallowing water shortly (~15 min) post vaccination. Patient was tearful but breathing normally. Walked under her own power from the pharmacy down to the Emergency Room for anxiety over anaphylaxis. Given dose of Vistaril in ER.


Changed on 12/24/2020

VAERS ID: 902837 Before After
VAERS Form:2
Age:29.0
Sex:Female
Location:Alaska
Vaccinated:2020-12-16
Onset:2020-12-16
Submitted:0000-00-00
Entered:2020-12-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK5730 / 1 - / IM

Administered by: Private      Purchased by: ??
Symptoms: Anxiety, Dysphagia, Tearfulness

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)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None None
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient feeling very anxious before and after vaccination. Described having difficulty swallowing water shortly (~15 min) post vaccination. Patient was tearful but breathing normally. Walked under her own power from the pharmacy down to the Emergency Room for anxiety over anaphylaxis. Given dose of Vistaril in ER.


Changed on 12/30/2020

VAERS ID: 902837 Before After
VAERS Form:2
Age:29.0
Sex:Female
Location:Alaska
Vaccinated:2020-12-16
Onset:2020-12-16
Submitted:0000-00-00
Entered:2020-12-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK5730 / 1 - / IM

Administered by: Private      Purchased by: ??
Symptoms: Anxiety, Dysphagia, Tearfulness

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)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None None
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient feeling very anxious before and after vaccination. Described having difficulty swallowing water shortly (~15 min) post vaccination. Patient was tearful but breathing normally. Walked under her own power from the pharmacy down to the Emergency Room for anxiety over anaphylaxis. Given dose of Vistaril in ER.


Changed on 5/7/2021

VAERS ID: 902837 Before After
VAERS Form:2
Age:29.0
Sex:Female
Location:Alaska
Vaccinated:2020-12-16
Onset:2020-12-16
Submitted:0000-00-00
Entered:2020-12-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK5730 / 1 - / IM

Administered by: Private      Purchased by: ??
Symptoms: Anxiety, Dysphagia, Tearfulness

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)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None None
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient feeling very anxious before and after vaccination. Described having difficulty swallowing water shortly (~15 min) post vaccination. Patient was tearful but breathing normally. Walked under her own power from the pharmacy down to the Emergency Room for anxiety over anaphylaxis. Given dose of Vistaril in ER.


Changed on 5/14/2021

VAERS ID: 902837 Before After
VAERS Form:2
Age:29.0
Sex:Female
Location:Alaska
Vaccinated:2020-12-16
Onset:2020-12-16
Submitted:0000-00-00
Entered:2020-12-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK5730 / 1 - / IM

Administered by: Private      Purchased by: ??
Symptoms: Anxiety, Dysphagia, Tearfulness

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)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None None
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient feeling very anxious before and after vaccination. Described having difficulty swallowing water shortly (~15 min) post vaccination. Patient was tearful but breathing normally. Walked under her own power from the pharmacy down to the Emergency Room for anxiety over anaphylaxis. Given dose of Vistaril in ER.

New Search

Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=902837&WAYBACKHISTORY=ON


Copyright © 2021 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166