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History of Changes from the VAERS Wayback Machine |
VAERS ID: | 902903 |
VAERS Form: | 2 |
Age: | 54.0 |
Sex: | Female |
Location: | North Carolina |
Vaccinated: | 2020-12-15 |
Onset: | 2020-12-15 |
Submitted: | 0000-00-00 |
Entered: | 2020-12-17 |
Vaccination / Manufacturer (1 vaccine) | Lot / Dose | Site / Route |
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH | EK5730 / 1 | LA / IM |
Administered by: Military Purchased by: ??
Symptoms: Erythema, Oedema peripheral, Urticaria
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: Hives - anthrax, flu unknown brand
Other Medications: Lotrel, Zyrtec, Zoloft, Albuterol and Prilosec
Current Illness: None reported
Preexisting Conditions: Asthma, Hypertension
Allergies: PCN, Lexapro
Diagnostic Lab Data: None
CDC 'Split Type':
Write-up: Hives within 3 hours lasted 12 hours. Left Arm edema and erythema 24 hours
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