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This is VAERS ID 905876

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History of Changes from the VAERS Wayback Machine

First Appeared on 12/30/2020

VAERS ID: 905876
VAERS Form:2
Age:53.0
Sex:Male
Location:Mississippi
Vaccinated:2020-12-21
Onset:2020-12-21
Submitted:0000-00-00
Entered:2020-12-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK5730 / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Rash, Urticaria, Paraesthesia oral

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:
Current Illness:
Preexisting Conditions:
Allergies: wasp stings
Diagnostic Lab Data: none
CDC 'Split Type':

Write-up: Hives, rash, and tingling to lips 14 minutes post injection


Changed on 5/7/2021

VAERS ID: 905876 Before After
VAERS Form:2
Age:53.0
Sex:Male
Location:Mississippi
Vaccinated:2020-12-21
Onset:2020-12-21
Submitted:0000-00-00
Entered:2020-12-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK5730 / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Rash, Urticaria, Paraesthesia oral

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:
Current Illness:
Preexisting Conditions:
Allergies: wasp stings stings
Diagnostic Lab Data: none
CDC 'Split Type':

Write-up: Hives, rash, and tingling to lips 14 minutes post injection


Changed on 5/21/2021

VAERS ID: 905876 Before After
VAERS Form:2
Age:53.0
Sex:Male
Location:Mississippi
Vaccinated:2020-12-21
Onset:2020-12-21
Submitted:0000-00-00
Entered:2020-12-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK5730 / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Rash, Urticaria, Paraesthesia oral

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:
Current Illness:
Preexisting Conditions:
Allergies: wasp stings stings
Diagnostic Lab Data: none
CDC 'Split Type':

Write-up: Hives, rash, and tingling to lips 14 minutes post injection


Changed on 6/4/2021

VAERS ID: 905876 Before After
VAERS Form:2
Age:53.0
Sex:Male
Location:Mississippi
Vaccinated:2020-12-21
Onset:2020-12-21
Submitted:0000-00-00
Entered:2020-12-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK5730 / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Rash, Urticaria, Paraesthesia oral

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:
Current Illness:
Preexisting Conditions:
Allergies: wasp stings
Diagnostic Lab Data: none
CDC 'Split Type': (blank) vsafe

Write-up: Hives, rash, and tingling to lips 14 minutes post injection

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