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This is VAERS ID 951087

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History of Changes from the VAERS Wayback Machine

First Appeared on 4/16/2021

VAERS ID: 951087
VAERS Form:2
Age:17.0
Sex:Female
Location:Rhode Island
Vaccinated:2021-01-15
Onset:2021-01-15
Submitted:0000-00-00
Entered:2021-01-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL1284 / 1 LA / SYR

Administered by: Senior Living      Purchased by: ??
Symptoms: Chills, Fatigue, Headache, Paraesthesia

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)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Blood pressure: 110/78 Temporal Temperature: 98.8 degrees F
CDC 'Split Type':

Write-up: 30 mins after IM injection: Left arm tingling 45 mins after IM injection: Left arm, Left shoulder, Left upper back tingling, Headache, chills, fatigue


Changed on 5/7/2021

VAERS ID: 951087 Before After
VAERS Form:2
Age:17.0
Sex:Female
Location:Rhode Island
Vaccinated:2021-01-15
Onset:2021-01-15
Submitted:0000-00-00
Entered:2021-01-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL1284 / 1 LA / SYR

Administered by: Senior Living      Purchased by: ??
Symptoms: Chills, Fatigue, Headache, Paraesthesia

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)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None None
Diagnostic Lab Data: Blood pressure: 110/78 Temporal Temperature: 98.8 degrees F
CDC 'Split Type':

Write-up: 30 mins after IM injection: Left arm tingling 45 mins after IM injection: Left arm, Left shoulder, Left upper back tingling, Headache, chills, fatigue


Changed on 5/21/2021

VAERS ID: 951087 Before After
VAERS Form:2
Age:17.0
Sex:Female
Location:Rhode Island
Vaccinated:2021-01-15
Onset:2021-01-15
Submitted:0000-00-00
Entered:2021-01-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL1284 / 1 LA / SYR

Administered by: Senior Living      Purchased by: ??
Symptoms: Chills, Fatigue, Headache, Paraesthesia

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)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None None
Diagnostic Lab Data: Blood pressure: 110/78 Temporal Temperature: 98.8 degrees F
CDC 'Split Type':

Write-up: 30 mins after IM injection: Left arm tingling 45 mins after IM injection: Left arm, Left shoulder, Left upper back tingling, Headache, chills, fatigue

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