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History of Changes from the VAERS Wayback Machine |
VAERS ID: | 902465 |
VAERS Form: | 2 |
Age: | 60.0 |
Sex: | Female |
Location: | Arkansas |
Vaccinated: | 2020-12-15 |
Onset: | 2020-12-15 |
Submitted: | 0000-00-00 |
Entered: | 2020-12-15 |
Vaccination / Manufacturer (1 vaccine) | Lot / Dose | Site / Route |
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH | EH9899 / 1 | RA / IM |
Administered by: Public Purchased by: ??
Symptoms: Dysgeusia, Paraesthesia, Parosmia, Sensory disturbance, Tremor, Oral pruritus, Paraesthesia oral
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: Lisinopril, HCTZ, lipitor, amyitrypline, lexapro, vitamins,
Current Illness: Bronchitis, finished prednisone on 12-13-20
Preexisting Conditions: hypertension, fibromyalgia
Allergies: Biaxin
Diagnostic Lab Data: BP.
CDC 'Split Type':
Write-up: Pt felt wave come over body @ 1218 starting in head and going down. Bad taste in mouth, tingling in body , legs, back , across stomach, BP 150/100 P 120@ 1219, EMS activated. BP 120/80, P 80 Pt alert and oriented, Pt declined transport and Benadryl. Symptoms come and go, pt feels better but then bad taste in mouth starts, shaking of hands, tingling starts again in stomach and back. @ 1300 pt requests Benadryl, 25 mg administered. Pt notified family by phone of circumstances and family in transit.@1324 BP 120/80, P 84, tongue tingling and pt reports smelling chemical smell. @1345 Pt complained of mouth itching, EMS activated and will transport to Medical Center. Pt oriented and transported at @13
Vaccinated: | 2020-12-15 |
Onset: | 2020-12-15 |
Submitted: | 0000-00-00 |
Entered: | 2020-12-15 |
Vaccination / Manufacturer (1 vaccine) | Lot / Dose | Site / Route |
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH | EH9899 / 1 | RA / IM |
Administered by: Public Purchased by: ??
Symptoms: Dysgeusia, Paraesthesia, Parosmia, Sensory disturbance, Tremor, Oral pruritus, Paraesthesia oral
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: Lisinopril, HCTZ, lipitor, amyitrypline, lexapro, vitamins,
Current Illness: Bronchitis, finished prednisone on 12-13-20
Preexisting Conditions: hypertension, fibromyalgia
Allergies: Biaxin
Diagnostic Lab Data: BP.
CDC 'Split Type': (blank) VSafe
Write-up: Pt felt wave come over body @ 1218 starting in head and going down. Bad taste in mouth, tingling in body , legs, back , across stomach, BP 150/100 P 120@ 1219, EMS activated. BP 120/80, P 80 Pt alert and oriented, Pt declined transport and Benadryl. Symptoms come and go, pt feels better but then bad taste in mouth starts, shaking of hands, tingling starts again in stomach and back. @ 1300 pt requests Benadryl, 25 mg administered. Pt notified family by phone of circumstances and family in transit.@1324 BP 120/80, P 84, tongue tingling and pt reports smelling chemical smell. @1345 Pt complained of mouth itching, EMS activated and will transport to Medical Center. Pt oriented and transported at @13
Vaccinated: | 2020-12-15 |
Onset: | 2020-12-15 |
Submitted: | 0000-00-00 |
Entered: | 2020-12-15 |
Vaccination / Manufacturer (1 vaccine) | Lot / Dose | Site / Route |
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH | EH9899 / 1 | RA / IM |
Administered by: Public Purchased by: ??
Symptoms: Dysgeusia, Paraesthesia, Parosmia, Sensory disturbance, Tremor, Oral pruritus, Paraesthesia oral
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: Lisinopril, HCTZ, lipitor, amyitrypline, lexapro, vitamins,
Current Illness: Bronchitis, finished prednisone on 12-13-20
Preexisting Conditions: hypertension, fibromyalgia
Allergies: Biaxin
Diagnostic Lab Data: BP.
CDC 'Split Type': VSafe (blank)
Write-up: Pt felt wave come over body @ 1218 starting in head and going down. Bad taste in mouth, tingling in body , legs, back , across stomach, BP 150/100 P 120@ 1219, EMS activated. BP 120/80, P 80 Pt alert and oriented, Pt declined transport and Benadryl. Symptoms come and go, pt feels better but then bad taste in mouth starts, shaking of hands, tingling starts again in stomach and back. @ 1300 pt requests Benadryl, 25 mg administered. Pt notified family by phone of circumstances and family in transit.@1324 BP 120/80, P 84, tongue tingling and pt reports smelling chemical smell. @1345 Pt complained of mouth itching, EMS activated and will transport to Medical Center. Pt oriented and transported at @13
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