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This is VAERS ID 903922

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History of Changes from the VAERS Wayback Machine

First Appeared on 12/24/2020

VAERS ID: 903922
VAERS Form:2
Age:30.0
Sex:Female
Location:Wisconsin
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 EJ1685 / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Dizziness, Dysphagia, Dysphonia, Dyspnoea, Pruritus, Rash, Throat tightness, Urticaria, Wheezing

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: Allegra, Singulair, Pepcid, Vit D
Current Illness: None
Preexisting Conditions: Migraines, allergic rhinitis
Allergies: Erenumab-aooe, Prednisone, Bees
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient complaint of rash,hives,difficulty breathing and swallowing, wheezing, throat tightness, hoarseness, itching and feeling light headed less than 10 minutes after receiving the vaccine. Patient received Benadryl 50mg IVP, Pepcid 20mg IVP, 0.3mg epi IM. EMS arrived and transported patient to ED. In ED, patient received second dose of 0.3mg epi IM. Patient monitored in ED for approximately 4 hours. Epi drip started and plan to admit patient for observation.


Changed on 12/30/2020

VAERS ID: 903922 Before After
VAERS Form:2
Age:30.0
Sex:Female
Location:Wisconsin
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 EJ1685 / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Dizziness, Dysphagia, Dysphonia, Dyspnoea, Pruritus, Rash, Throat tightness, Urticaria, Wheezing

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: Allegra, Singulair, Pepcid, Vit D
Current Illness: None
Preexisting Conditions: Migraines, allergic rhinitis
Allergies: Erenumab-aooe, Prednisone, Bees Bees
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient complaint of rash,hives,difficulty breathing and swallowing, wheezing, throat tightness, hoarseness, itching and feeling light headed less than 10 minutes after receiving the vaccine. Patient received Benadryl 50mg IVP, Pepcid 20mg IVP, 0.3mg epi IM. EMS arrived and transported patient to ED. In ED, patient received second dose of 0.3mg epi IM. Patient monitored in ED for approximately 4 hours. Epi drip started and plan to admit patient for observation.


Changed on 5/7/2021

VAERS ID: 903922 Before After
VAERS Form:2
Age:30.0
Sex:Female
Location:Wisconsin
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 EJ1685 / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Dizziness, Dysphagia, Dysphonia, Dyspnoea, Pruritus, Rash, Throat tightness, Urticaria, Wheezing

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: Allegra, Singulair, Pepcid, Vit D
Current Illness: None
Preexisting Conditions: Migraines, allergic rhinitis
Allergies: Erenumab-aooe, Prednisone, Bees Bees
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient complaint of rash,hives,difficulty breathing and swallowing, wheezing, throat tightness, hoarseness, itching and feeling light headed less than 10 minutes after receiving the vaccine. Patient received Benadryl 50mg IVP, Pepcid 20mg IVP, 0.3mg epi IM. EMS arrived and transported patient to ED. In ED, patient received second dose of 0.3mg epi IM. Patient monitored in ED for approximately 4 hours. Epi drip started and plan to admit patient for observation.


Changed on 5/14/2021

VAERS ID: 903922 Before After
VAERS Form:2
Age:30.0
Sex:Female
Location:Wisconsin
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 EJ1685 / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Dizziness, Dysphagia, Dysphonia, Dyspnoea, Pruritus, Rash, Throat tightness, Urticaria, Wheezing

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: Allegra, Singulair, Pepcid, Vit D
Current Illness: None
Preexisting Conditions: Migraines, allergic rhinitis
Allergies: Erenumab-aooe, Prednisone, Bees Bees
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient complaint of rash,hives,difficulty breathing and swallowing, wheezing, throat tightness, hoarseness, itching and feeling light headed less than 10 minutes after receiving the vaccine. Patient received Benadryl 50mg IVP, Pepcid 20mg IVP, 0.3mg epi IM. EMS arrived and transported patient to ED. In ED, patient received second dose of 0.3mg epi IM. Patient monitored in ED for approximately 4 hours. Epi drip started and plan to admit patient for observation.

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