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This is VAERS ID 906324

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History of Changes from the VAERS Wayback Machine

First Appeared on 12/30/2020

VAERS ID: 906324
VAERS Form:2
Age:52.0
Sex:Female
Location:Florida
Vaccinated:2020-12-22
Onset:2020-12-22
Submitted:0000-00-00
Entered:2020-12-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EH9899 / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Blood pressure increased, Cold sweat, Feeling cold, Full blood count, Heart rate increased, Swelling, Urticaria, Metabolic function test

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: CLARITAN 10MFG AS NEEDED FOR ALLERGIES, ZINC, AND VITAMIN D 2000 IU
Current Illness: NONE
Preexisting Conditions: NONE
Allergies: NO KNOWN ALLERGIES
Diagnostic Lab Data: CBC and CMP. Results pending.
CDC 'Split Type':

Write-up: Increased heart rate, increased blood pressure, cold/clammy feeling, urticaria (neck), swelling in neck and chest. At vaccine clinic area, Benadryl 50mg IM given. Rapid response called via overhead page. Patient taken to ER from vaccine clinic. In ED, given famotidine 20mg IV, methylprednisolone 125mg IV.


Changed on 5/7/2021

VAERS ID: 906324 Before After
VAERS Form:2
Age:52.0
Sex:Female
Location:Florida
Vaccinated:2020-12-22
Onset:2020-12-22
Submitted:0000-00-00
Entered:2020-12-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EH9899 / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Blood pressure increased, Cold sweat, Feeling cold, Full blood count, Heart rate increased, Swelling, Urticaria, Metabolic function test

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: CLARITAN 10MFG AS NEEDED FOR ALLERGIES, ZINC, AND VITAMIN D 2000 IU
Current Illness: NONE
Preexisting Conditions: NONE
Allergies: NO KNOWN ALLERGIES ALLERGIES
Diagnostic Lab Data: CBC and CMP. Results pending.
CDC 'Split Type':

Write-up: Increased heart rate, increased blood pressure, cold/clammy feeling, urticaria (neck), swelling in neck and chest. At vaccine clinic area, Benadryl 50mg IM given. Rapid response called via overhead page. Patient taken to ER from vaccine clinic. In ED, given famotidine 20mg IV, methylprednisolone 125mg IV.


Changed on 5/21/2021

VAERS ID: 906324 Before After
VAERS Form:2
Age:52.0
Sex:Female
Location:Florida
Vaccinated:2020-12-22
Onset:2020-12-22
Submitted:0000-00-00
Entered:2020-12-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EH9899 / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Blood pressure increased, Cold sweat, Feeling cold, Full blood count, Heart rate increased, Swelling, Urticaria, Metabolic function test

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: CLARITAN 10MFG AS NEEDED FOR ALLERGIES, ZINC, AND VITAMIN D 2000 IU
Current Illness: NONE
Preexisting Conditions: NONE
Allergies: NO KNOWN ALLERGIES ALLERGIES
Diagnostic Lab Data: CBC and CMP. Results pending.
CDC 'Split Type':

Write-up: Increased heart rate, increased blood pressure, cold/clammy feeling, urticaria (neck), swelling in neck and chest. At vaccine clinic area, Benadryl 50mg IM given. Rapid response called via overhead page. Patient taken to ER from vaccine clinic. In ED, given famotidine 20mg IV, methylprednisolone 125mg IV.

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