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History of Changes from the VAERS Wayback Machine |
VAERS ID: | 902728 |
VAERS Form: | 2 |
Age: | 34.0 |
Sex: | Female |
Location: | Texas |
Vaccinated: | 2020-12-15 |
Onset: | 2020-12-16 |
Submitted: | 0000-00-00 |
Entered: | 2020-12-16 |
Vaccination / Manufacturer (1 vaccine) | Lot / Dose | Site / Route |
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH | PAA156057 / 1 | RA / IM |
Administered by: Private Purchased by: ??
Symptoms: Peripheral swelling, Product administered at inappropriate site
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: BCPs (birth control pills)
Current Illness: None
Preexisting Conditions: MigRaines as 12/16/20
Allergies: Penicillin + Sulfa
Diagnostic Lab Data: (-)
CDC 'Split Type':
Write-up: Swelling on arm. Placement lower than deltoid, 4 cm. treated with corticosteroids, antihistamines
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