This is VAERS ID 902748

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History of Changes from the VAERS Wayback Machine

First Appeared on 12/18/2020

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

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Changed on 1/7/2021

(Changed: CDC Split Type)

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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