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This is VAERS ID 906312

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History of Changes from the VAERS Wayback Machine

First Appeared on 12/30/2020

VAERS ID: 906312
VAERS Form:2
Age:28.0
Sex:Female
Location:Illinois
Vaccinated:2020-12-18
Onset:2020-12-18
Submitted:0000-00-00
Entered:2020-12-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Chills, Dizziness, Nausea, Rash, Urticaria

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: n/a
Current Illness: n/a
Preexisting Conditions: n/a
Allergies: n/a
Diagnostic Lab Data: 12/18 went to the ER. received fluids, Benadryl, pepcid
CDC 'Split Type':

Write-up: dizziness, light headedness, severe nausea, rash/hives over chest and back and forearms, severe chills/shivering


Changed on 5/7/2021

VAERS ID: 906312 Before After
VAERS Form:2
Age:28.0
Sex:Female
Location:Illinois
Vaccinated:2020-12-18
Onset:2020-12-18
Submitted:0000-00-00
Entered:2020-12-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Chills, Dizziness, Nausea, Rash, Urticaria

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: n/a
Current Illness: n/a
Preexisting Conditions: n/a
Allergies: n/a n/a
Diagnostic Lab Data: 12/18 went to the ER. received fluids, Benadryl, pepcid
CDC 'Split Type':

Write-up: dizziness, light headedness, severe nausea, rash/hives over chest and back and forearms, severe chills/shivering


Changed on 5/21/2021

VAERS ID: 906312 Before After
VAERS Form:2
Age:28.0
Sex:Female
Location:Illinois
Vaccinated:2020-12-18
Onset:2020-12-18
Submitted:0000-00-00
Entered:2020-12-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Chills, Dizziness, Nausea, Rash, Urticaria

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: n/a
Current Illness: n/a
Preexisting Conditions: n/a
Allergies: n/a n/a
Diagnostic Lab Data: 12/18 went to the ER. received fluids, Benadryl, pepcid
CDC 'Split Type':

Write-up: dizziness, light headedness, severe nausea, rash/hives over chest and back and forearms, severe chills/shivering

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