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This is VAERS ID 903886

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History of Changes from the VAERS Wayback Machine

First Appeared on 12/24/2020

VAERS ID: 903886
VAERS Form:2
Age:30.0
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 RA / SYR

Administered by: Other      Purchased by: ??
Symptoms: Urticaria

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

Write-up: Patient presented with hives to upper extremities approximately 2 hours after receiving the vaccine.


Changed on 12/30/2020

VAERS ID: 903886 Before After
VAERS Form:2
Age:30.0
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 RA / SYR

Administered by: Other      Purchased by: ??
Symptoms: Urticaria

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

Write-up: Patient presented with hives to upper extremities approximately 2 hours after receiving the vaccine.


Changed on 5/7/2021

VAERS ID: 903886 Before After
VAERS Form:2
Age:30.0
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 RA / SYR

Administered by: Other      Purchased by: ??
Symptoms: Urticaria

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

Write-up: Patient presented with hives to upper extremities approximately 2 hours after receiving the vaccine.


Changed on 5/14/2021

VAERS ID: 903886 Before After
VAERS Form:2
Age:30.0
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 RA / SYR

Administered by: Other      Purchased by: ??
Symptoms: Urticaria

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

Write-up: Patient presented with hives to upper extremities approximately 2 hours after receiving the vaccine.

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