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This is VAERS ID 905897

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History of Changes from the VAERS Wayback Machine

First Appeared on 12/30/2020

VAERS ID: 905897
VAERS Form:2
Age:23.0
Sex:Female
Location:Missouri
Vaccinated:2020-12-17
Onset:2020-12-17
Submitted:0000-00-00
Entered:2020-12-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EH9899 / 1 AR / IM

Administered by: Private      Purchased by: ??
Symptoms: Swollen tongue, Throat irritation, Tongue pruritus, Pharyngeal swelling

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: Etonogestrel (Nexplanon), Mesalamine (LIALDA) 1.2g tablet, extended release
Current Illness: none
Preexisting Conditions: Lymphocytic colitis
Allergies: Amoxicillin
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: approximately 30 minutes after the vaccine the patient began to experience itching and swelling of the throat and tongue.


Changed on 5/7/2021

VAERS ID: 905897 Before After
VAERS Form:2
Age:23.0
Sex:Female
Location:Missouri
Vaccinated:2020-12-17
Onset:2020-12-17
Submitted:0000-00-00
Entered:2020-12-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EH9899 / 1 AR / IM

Administered by: Private      Purchased by: ??
Symptoms: Swollen tongue, Throat irritation, Tongue pruritus, Pharyngeal swelling

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: Etonogestrel (Nexplanon), Mesalamine (LIALDA) 1.2g tablet, extended release
Current Illness: none
Preexisting Conditions: Lymphocytic colitis
Allergies: Amoxicillin Amoxicillin
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: approximately 30 minutes after the vaccine the patient began to experience itching and swelling of the throat and tongue.


Changed on 5/21/2021

VAERS ID: 905897 Before After
VAERS Form:2
Age:23.0
Sex:Female
Location:Missouri
Vaccinated:2020-12-17
Onset:2020-12-17
Submitted:0000-00-00
Entered:2020-12-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EH9899 / 1 AR / IM

Administered by: Private      Purchased by: ??
Symptoms: Swollen tongue, Throat irritation, Tongue pruritus, Pharyngeal swelling

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: Etonogestrel (Nexplanon), Mesalamine (LIALDA) 1.2g tablet, extended release
Current Illness: none
Preexisting Conditions: Lymphocytic colitis
Allergies: Amoxicillin Amoxicillin
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: approximately 30 minutes after the vaccine the patient began to experience itching and swelling of the throat and tongue.

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