National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 903819

Government Disclaimer on use of this data

History of Changes from the VAERS Wayback Machine

First Appeared on 12/24/2020

VAERS ID: 903819
VAERS Form:2
Age:62.0
Sex:Female
Location:New York
Vaccinated:2020-12-18
Onset:2020-12-18
Submitted:0000-00-00
Entered:2020-12-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private      Purchased by: ??
Symptoms: Dizziness, Flushing, Palpitations, Tachycardia, Urticaria

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: levothyroxine 88 mcg
Current Illness: none
Preexisting Conditions: hypothyroidism
Allergies: penicillin (severe hives, swelling of feet and hands)
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: tachycardia, flushing, severe hives on arm received vaccine, dizziness, palpitations


Changed on 12/30/2020

VAERS ID: 903819 Before After
VAERS Form:2
Age:62.0
Sex:Female
Location:New York
Vaccinated:2020-12-18
Onset:2020-12-18
Submitted:0000-00-00
Entered:2020-12-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private      Purchased by: ??
Symptoms: Dizziness, Flushing, Palpitations, Tachycardia, Urticaria

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: levothyroxine 88 mcg
Current Illness: none
Preexisting Conditions: hypothyroidism
Allergies: penicillin (severe hives, swelling of feet and hands) hands)
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: tachycardia, flushing, severe hives on arm received vaccine, dizziness, palpitations


Changed on 5/7/2021

VAERS ID: 903819 Before After
VAERS Form:2
Age:62.0
Sex:Female
Location:New York
Vaccinated:2020-12-18
Onset:2020-12-18
Submitted:0000-00-00
Entered:2020-12-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private      Purchased by: ??
Symptoms: Dizziness, Flushing, Palpitations, Tachycardia, Urticaria

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: levothyroxine 88 mcg
Current Illness: none
Preexisting Conditions: hypothyroidism
Allergies: penicillin (severe hives, swelling of feet and hands) hands)
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: tachycardia, flushing, severe hives on arm received vaccine, dizziness, palpitations


Changed on 5/14/2021

VAERS ID: 903819 Before After
VAERS Form:2
Age:62.0
Sex:Female
Location:New York
Vaccinated:2020-12-18
Onset:2020-12-18
Submitted:0000-00-00
Entered:2020-12-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private      Purchased by: ??
Symptoms: Dizziness, Flushing, Palpitations, Tachycardia, Urticaria

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: levothyroxine 88 mcg
Current Illness: none
Preexisting Conditions: hypothyroidism
Allergies: penicillin (severe hives, swelling of feet and hands) hands)
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: tachycardia, flushing, severe hives on arm received vaccine, dizziness, palpitations

New Search

Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=903819&WAYBACKHISTORY=ON


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