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This is VAERS ID 903872

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History of Changes from the VAERS Wayback Machine

First Appeared on 4/1/2021

VAERS ID: 903872
VAERS Form:2
Age:48.0
Sex:Female
Location:California
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 EK5730 / 1 AR / IM

Administered by: Private      Purchased by: ??
Symptoms: Cough, Dysphonia, Swollen tongue, 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)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: unknown
Preexisting Conditions: unknown
Allergies: As stated by patient: wheat and iron
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Staff came back 1 hour post vaccine administration s/o tingling lips, tongue swelling, raspy throat. Started coughing continuously after 5 minutes. SpO2 95% Pulse 95 1448 - epi pen left thigh, benadryl 50 mg IM R deltoid Taken to ED


Changed on 5/7/2021

VAERS ID: 903872 Before After
VAERS Form:2
Age:48.0
Sex:Female
Location:California
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 EK5730 / 1 AR / IM

Administered by: Private      Purchased by: ??
Symptoms: Cough, Dysphonia, Swollen tongue, 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)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: unknown
Preexisting Conditions: unknown
Allergies: As stated by patient: wheat and iron iron
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Staff came back 1 hour post vaccine administration s/o tingling lips, tongue swelling, raspy throat. Started coughing continuously after 5 minutes. SpO2 95% Pulse 95 1448 - epi pen left thigh, benadryl 50 mg IM R deltoid Taken to ED


Changed on 5/21/2021

VAERS ID: 903872 Before After
VAERS Form:2
Age:48.0
Sex:Female
Location:California
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 EK5730 / 1 AR / IM

Administered by: Private      Purchased by: ??
Symptoms: Cough, Dysphonia, Swollen tongue, 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)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: unknown
Preexisting Conditions: unknown
Allergies: As stated by patient: wheat and iron iron
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Staff came back 1 hour post vaccine administration s/o tingling lips, tongue swelling, raspy throat. Started coughing continuously after 5 minutes. SpO2 95% Pulse 95 1448 - epi pen left thigh, benadryl 50 mg IM R deltoid Taken to ED

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