National Vaccine
Information Center
Your Health. Your Family. Your Choice.

 MedAlerts.org
Search Results

This is VAERS ID 902777

Government Disclaimer on use of this data

History of Changes from the VAERS Wayback Machine

Color Schemes (Before/After):

First Appeared on 12/18/2020

VAERS ID: 902777
VAERS Form:2
Age:45.0
Sex:Female
Location:Indiana
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 - / UNK - / -

Administered by: Work      Purchased by: ??
Symptoms: Erythema, Pruritus

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: Viibryd, synthroid, Zyrtec, fish oil
Current Illness: none known
Preexisting Conditions:
Allergies: sulfa
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: redness, itching to face, armpit, and neck

Changed on 12/24/2020

(Changed: CDC Split Type)

VAERS ID: 902777 Before After
VAERS Form:2
Age:45.0
Sex:Female
Location:Indiana
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 - / UNK - / -

Administered by: Work      Purchased by: ??
Symptoms: Erythema, Pruritus

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: Viibryd, synthroid, Zyrtec, fish oil
Current Illness: none known
Preexisting Conditions:
Allergies: sulfa
Diagnostic Lab Data:
CDC 'Split Type': (blank) VSafe

Write-up: redness, itching to face, armpit, and neck

Changed on 1/7/2021

(Changed: CDC Split Type)

VAERS ID: 902777 Before After
VAERS Form:2
Age:45.0
Sex:Female
Location:Indiana
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 - / UNK - / -

Administered by: Work      Purchased by: ??
Symptoms: Erythema, Pruritus

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: Viibryd, synthroid, Zyrtec, fish oil
Current Illness: none known
Preexisting Conditions:
Allergies: sulfa
Diagnostic Lab Data:
CDC 'Split Type': VSafe (blank)

Write-up: redness, itching to face, armpit, and neck

New Search


Copyright © 2024 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166