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History of Changes from the VAERS Wayback Machine |
VAERS ID: | 902722 |
VAERS Form: | 2 |
Age: | 45.0 |
Sex: | Female |
Location: | Georgia |
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 | EH9899 / 1 | LA / IM |
Administered by: Public Purchased by: ??
Symptoms: Flushing, Pruritus, Rash
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: Unknown
Current Illness: unknown
Preexisting Conditions: unknown
Allergies: unknown
Diagnostic Lab Data:
CDC 'Split Type':
Write-up: Pfizer-Bio-Tech COVID-19 Vaccine: Individual was given vaccine at 10:50 am. 10 minutes after receiving the vaccine individual developed itchy flushed skin with a rash. She was given Benadryl 50 mg IM in Right arm at 11:00 am. 11:37 am the itchy skin was less intensified and vitals were stable. Individual went home with husband.
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