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History of Changes from the VAERS Wayback Machine |
VAERS ID: | 902748 |
VAERS Form: | 2 |
Age: | 34.0 |
Sex: | Female |
Location: | Pennsylvania |
Vaccinated: | 2020-12-15 |
Onset: | 2020-12-15 |
Submitted: | 0000-00-00 |
Entered: | 2020-12-16 |
Vaccination / Manufacturer (1 vaccine) | Lot / Dose | Site / Route |
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH | PA156051 / 1 | RA / - |
Administered by: Private Purchased by: ??
Symptoms: Chills, Pain, Pyrexia
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: Levothyroxine , Wellbutrin , Bustar, trazodone , Lithium Carbonate ER , vistaril , Propranolol, MAXALT
Current Illness: COVID one week before
Preexisting Conditions: Bipolar Disorder
Allergies: NA
Diagnostic Lab Data: N/a
CDC 'Split Type': v-safe
Write-up: Chills, Body Ache, Fever
Vaccinated: | 2020-12-15 |
Onset: | 2020-12-15 |
Submitted: | 0000-00-00 |
Entered: | 2020-12-16 |
Vaccination / Manufacturer (1 vaccine) | Lot / Dose | Site / Route |
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH | PA156051 / 1 | RA / - |
Administered by: Private Purchased by: ??
Symptoms: Chills, Pain, Pyrexia
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: Levothyroxine , Wellbutrin , Bustar, trazodone , Lithium Carbonate ER , vistaril , Propranolol, MAXALT
Current Illness: COVID one week before
Preexisting Conditions: Bipolar Disorder
Allergies: NA
Diagnostic Lab Data: N/a
CDC 'Split Type': v-safe vsafe
Write-up: Chills, Body Ache, Fever
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