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This is VAERS ID 903081

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History of Changes from the VAERS Wayback Machine

First Appeared on 12/18/2020

VAERS ID: 903081
VAERS Form:2
Age:35.0
Sex:Female
Location:New York
Vaccinated:2020-12-17
Onset:2020-12-17
Submitted:0000-00-00
Entered:2020-12-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK5730 / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Confusional state, Fatigue, Headache, Myalgia, Somnolence

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: Fluoxetine 60mg, Dolovent, Junel, Klonopin
Current Illness: Acute migraine
Preexisting Conditions: Migraines, Depression
Allergies: Peanuts
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Muscle ache, fatigue, drowsiness, brief confusion, bilateral headache, onset 11 AM, duration 2-3 hours


Changed on 12/24/2020

VAERS ID: 903081 Before After
VAERS Form:2
Age:35.0
Sex:Female
Location:New York
Vaccinated:2020-12-17
Onset:2020-12-17
Submitted:0000-00-00
Entered:2020-12-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK5730 / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Confusional state, Fatigue, Headache, Myalgia, Somnolence

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: Fluoxetine 60mg, Dolovent, Junel, Klonopin
Current Illness: Acute migraine
Preexisting Conditions: Migraines, Depression
Allergies: Peanuts Peanuts
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Muscle ache, fatigue, drowsiness, brief confusion, bilateral headache, onset 11 AM, duration 2-3 hours


Changed on 12/30/2020

VAERS ID: 903081 Before After
VAERS Form:2
Age:35.0
Sex:Female
Location:New York
Vaccinated:2020-12-17
Onset:2020-12-17
Submitted:0000-00-00
Entered:2020-12-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK5730 / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Confusional state, Fatigue, Headache, Myalgia, Somnolence

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: Fluoxetine 60mg, Dolovent, Junel, Klonopin
Current Illness: Acute migraine
Preexisting Conditions: Migraines, Depression
Allergies: Peanuts Peanuts
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Muscle ache, fatigue, drowsiness, brief confusion, bilateral headache, onset 11 AM, duration 2-3 hours


Changed on 5/7/2021

VAERS ID: 903081 Before After
VAERS Form:2
Age:35.0
Sex:Female
Location:New York
Vaccinated:2020-12-17
Onset:2020-12-17
Submitted:0000-00-00
Entered:2020-12-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK5730 / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Confusional state, Fatigue, Headache, Myalgia, Somnolence

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: Fluoxetine 60mg, Dolovent, Junel, Klonopin
Current Illness: Acute migraine
Preexisting Conditions: Migraines, Depression
Allergies: Peanuts Peanuts
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Muscle ache, fatigue, drowsiness, brief confusion, bilateral headache, onset 11 AM, duration 2-3 hours


Changed on 5/21/2021

VAERS ID: 903081 Before After
VAERS Form:2
Age:35.0
Sex:Female
Location:New York
Vaccinated:2020-12-17
Onset:2020-12-17
Submitted:0000-00-00
Entered:2020-12-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK5730 / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Confusional state, Fatigue, Headache, Myalgia, Somnolence

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: Fluoxetine 60mg, Dolovent, Junel, Klonopin
Current Illness: Acute migraine
Preexisting Conditions: Migraines, Depression
Allergies: Peanuts Peanuts
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Muscle ache, fatigue, drowsiness, brief confusion, bilateral headache, onset 11 AM, duration 2-3 hours

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