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History of Changes from the VAERS Wayback Machine |
VAERS ID: | 902763 |
VAERS Form: | 2 |
Age: | 59.0 |
Sex: | Female |
Location: | Rhode Island |
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: Private Purchased by: ??
Symptoms: Injection site pain, Injection site swelling
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)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: HCTZ, gabapentin
Current Illness: None
Preexisting Conditions:
Allergies: latex, thimerosal
Diagnostic Lab Data:
CDC 'Split Type':
Write-up: Soreness and swelling at injection site
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