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History of Changes from the VAERS Wayback Machine |
VAERS ID: | 902768 |
VAERS Form: | 2 |
Age: | 42.0 |
Sex: | Female |
Location: | Texas |
Vaccinated: | 2020-12-16 |
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 | EK5730 / 1 | RA / IM |
Administered by: Private Purchased by: ??
Symptoms: Heart rate decreased, Nausea, Tremor
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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:
Current Illness:
Preexisting Conditions:
Allergies: Ciprofloxacin-rash Pregablin-insomnia
Diagnostic Lab Data:
CDC 'Split Type':
Write-up: Nausea, tremors, and decrease in HR. Patient taken to ED. No epinephrine injection administered.
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