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This is VAERS ID 905761

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History of Changes from the VAERS Wayback Machine

First Appeared on 12/30/2020

VAERS ID: 905761
VAERS Form:2
Age:50.0
Sex:Female
Location:Texas
Vaccinated:2020-12-19
Onset:2020-12-19
Submitted:0000-00-00
Entered:2020-12-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ1685 / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Blood magnesium, Blood thyroid stimulating hormone, Disturbance in attention, Dizziness, Full blood count, Glomerular filtration rate, Glycosylated haemoglobin, Headache, Lipids, Pyrexia, Speech disorder, Swollen tongue, Metabolic function test, Pharyngeal swelling, SARS-CoV-2 test

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? Yes
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Turmeric Multivitamin Viibryd at bedtime 12/18/20 Ditropan
Current Illness: None
Preexisting Conditions: Migraine Headaches Arthritis
Allergies: PCN Trees Dust Mold Ants Bees Multiple food allergies unknown at this time
Diagnostic Lab Data: 12/19/2020-COVID 19 nasal swab; Est GFR; Thyroid stimulating; Mag level; lipid level; BMP; CBC Hemoglobin A1c.- 12/21/2020
CDC 'Split Type':

Write-up: At one and a half hours after receiving her vaccine, developed tongue and throat swelling, went immediately to the ER. She was treated in the ER and was discharged to home with EPI pen. She still has the following symptoms headache, dizziness, lightheaded, fever 99.2. Difficulty concentration and talking. She is following up with her primary care physician on 12/21/2020


Changed on 5/7/2021

VAERS ID: 905761 Before After
VAERS Form:2
Age:50.0
Sex:Female
Location:Texas
Vaccinated:2020-12-19
Onset:2020-12-19
Submitted:0000-00-00
Entered:2020-12-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ1685 / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Blood magnesium, Blood thyroid stimulating hormone, Disturbance in attention, Dizziness, Full blood count, Glomerular filtration rate, Glycosylated haemoglobin, Headache, Lipids, Pyrexia, Speech disorder, Swollen tongue, Metabolic function test, Pharyngeal swelling, SARS-CoV-2 test

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? Yes
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Turmeric Multivitamin Viibryd at bedtime 12/18/20 Ditropan
Current Illness: None
Preexisting Conditions: Migraine Headaches Arthritis
Allergies: PCN Trees Dust Mold Ants Bees Multiple food allergies unknown at this time time
Diagnostic Lab Data: 12/19/2020-COVID 19 nasal swab; Est GFR; Thyroid stimulating; Mag level; lipid level; BMP; CBC Hemoglobin A1c.- 12/21/2020
CDC 'Split Type':

Write-up: At one and a half hours after receiving her vaccine, developed tongue and throat swelling, went immediately to the ER. She was treated in the ER and was discharged to home with EPI pen. She still has the following symptoms headache, dizziness, lightheaded, fever 99.2. Difficulty concentration and talking. She is following up with her primary care physician on 12/21/2020


Changed on 5/21/2021

VAERS ID: 905761 Before After
VAERS Form:2
Age:50.0
Sex:Female
Location:Texas
Vaccinated:2020-12-19
Onset:2020-12-19
Submitted:0000-00-00
Entered:2020-12-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ1685 / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Blood magnesium, Blood thyroid stimulating hormone, Disturbance in attention, Dizziness, Full blood count, Glomerular filtration rate, Glycosylated haemoglobin, Headache, Lipids, Pyrexia, Speech disorder, Swollen tongue, Metabolic function test, Pharyngeal swelling, SARS-CoV-2 test

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? Yes
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Turmeric Multivitamin Viibryd at bedtime 12/18/20 Ditropan
Current Illness: None
Preexisting Conditions: Migraine Headaches Arthritis
Allergies: PCN Trees Dust Mold Ants Bees Multiple food allergies unknown at this time time
Diagnostic Lab Data: 12/19/2020-COVID 19 nasal swab; Est GFR; Thyroid stimulating; Mag level; lipid level; BMP; CBC Hemoglobin A1c.- 12/21/2020
CDC 'Split Type':

Write-up: At one and a half hours after receiving her vaccine, developed tongue and throat swelling, went immediately to the ER. She was treated in the ER and was discharged to home with EPI pen. She still has the following symptoms headache, dizziness, lightheaded, fever 99.2. Difficulty concentration and talking. She is following up with her primary care physician on 12/21/2020

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