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This is VAERS ID 903945

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History of Changes from the VAERS Wayback Machine

First Appeared on 12/24/2020

VAERS ID: 903945
VAERS Form:2
Age:60.0
Sex:Female
Location:Alaska
Vaccinated:2020-12-16
Onset:2020-12-16
Submitted:0000-00-00
Entered:2020-12-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EH9899 / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Chest X-ray, Dyspnoea, Electrocardiogram, Pruritus, Throat tightness, Urticaria, Laboratory test, Immediate post-injection reaction

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: Allegra, lisinopril, dexilant,Motrin, victoza, insulin
Current Illness: Diabetes, hypertension, asthma
Preexisting Conditions: As above
Allergies: Latex, asprin, sulpha History of allergic reaction to hepatitis andtetnus(40 years ago), anaphylaxis to jellyfish sting Allergy to eggs, milk
Diagnostic Lab Data: 12/16/2020-no labs, IV Benadryl, Pepcid and decadron, I?m epinephrine sent home at 9 pm 12/17/2020- took epi pen at home in the morning back to ER given IV decadron, labs, ekg, chest X-ray done discharged home at 6pm
CDC 'Split Type':

Write-up: Itching started immediately, throat tightness SOB in about 10 minutes with hives on chest


Changed on 12/30/2020

VAERS ID: 903945 Before After
VAERS Form:2
Age:60.0
Sex:Female
Location:Alaska
Vaccinated:2020-12-16
Onset:2020-12-16
Submitted:0000-00-00
Entered:2020-12-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EH9899 / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Chest X-ray, Dyspnoea, Electrocardiogram, Pruritus, Throat tightness, Urticaria, Laboratory test, Immediate post-injection reaction

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: Allegra, lisinopril, dexilant,Motrin, victoza, insulin
Current Illness: Diabetes, hypertension, asthma
Preexisting Conditions: As above
Allergies: Latex, asprin, sulpha History of allergic reaction to hepatitis andtetnus(40 years ago), anaphylaxis to jellyfish sting Allergy to eggs, milk milk
Diagnostic Lab Data: 12/16/2020-no labs, IV Benadryl, Pepcid and decadron, I?m epinephrine sent home at 9 pm 12/17/2020- took epi pen at home in the morning back to ER given IV decadron, labs, ekg, chest X-ray done discharged home at 6pm
CDC 'Split Type':

Write-up: Itching started immediately, throat tightness SOB in about 10 minutes with hives on chest


Changed on 5/7/2021

VAERS ID: 903945 Before After
VAERS Form:2
Age:60.0
Sex:Female
Location:Alaska
Vaccinated:2020-12-16
Onset:2020-12-16
Submitted:0000-00-00
Entered:2020-12-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EH9899 / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Chest X-ray, Dyspnoea, Electrocardiogram, Pruritus, Throat tightness, Urticaria, Laboratory test, Immediate post-injection reaction

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: Allegra, lisinopril, dexilant,Motrin, victoza, insulin
Current Illness: Diabetes, hypertension, asthma
Preexisting Conditions: As above
Allergies: Latex, asprin, sulpha History of allergic reaction to hepatitis andtetnus(40 years ago), anaphylaxis to jellyfish sting Allergy to eggs, milk milk
Diagnostic Lab Data: 12/16/2020-no labs, IV Benadryl, Pepcid and decadron, I?m epinephrine sent home at 9 pm 12/17/2020- took epi pen at home in the morning back to ER given IV decadron, labs, ekg, chest X-ray done discharged home at 6pm
CDC 'Split Type':

Write-up: Itching started immediately, throat tightness SOB in about 10 minutes with hives on chest


Changed on 5/14/2021

VAERS ID: 903945 Before After
VAERS Form:2
Age:60.0
Sex:Female
Location:Alaska
Vaccinated:2020-12-16
Onset:2020-12-16
Submitted:0000-00-00
Entered:2020-12-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EH9899 / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Chest X-ray, Dyspnoea, Electrocardiogram, Pruritus, Throat tightness, Urticaria, Laboratory test, Immediate post-injection reaction

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: Allegra, lisinopril, dexilant,Motrin, victoza, insulin
Current Illness: Diabetes, hypertension, asthma
Preexisting Conditions: As above
Allergies: Latex, asprin, sulpha History of allergic reaction to hepatitis andtetnus(40 years ago), anaphylaxis to jellyfish sting Allergy to eggs, milk milk
Diagnostic Lab Data: 12/16/2020-no labs, IV Benadryl, Pepcid and decadron, I?m epinephrine sent home at 9 pm 12/17/2020- took epi pen at home in the morning back to ER given IV decadron, labs, ekg, chest X-ray done discharged home at 6pm
CDC 'Split Type':

Write-up: Itching started immediately, throat tightness SOB in about 10 minutes with hives on chest


Changed on 6/4/2021

VAERS ID: 903945 Before After
VAERS Form:2
Age:60.0
Sex:Female
Location:Alaska
Vaccinated:2020-12-16
Onset:2020-12-16
Submitted:0000-00-00
Entered:2020-12-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EH9899 / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Chest X-ray, Dyspnoea, Electrocardiogram, Pruritus, Throat tightness, Urticaria, Laboratory test, Immediate post-injection reaction

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: Allegra, lisinopril, dexilant,Motrin, victoza, insulin
Current Illness: Diabetes, hypertension, asthma
Preexisting Conditions: As above
Allergies: Latex, asprin, sulpha History of allergic reaction to hepatitis andtetnus(40 years ago), anaphylaxis to jellyfish sting Allergy to eggs, milk
Diagnostic Lab Data: 12/16/2020-no labs, IV Benadryl, Pepcid and decadron, I?m epinephrine sent home at 9 pm 12/17/2020- took epi pen at home in the morning back to ER given IV decadron, labs, ekg, chest X-ray done discharged home at 6pm
CDC 'Split Type': (blank) vsafe

Write-up: Itching started immediately, throat tightness SOB in about 10 minutes with hives on chest

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